F 


THE  LIBRARY 

OF 

THE  UNIVERSITY 

OF  CALIFORNIA 

LOS  ANGELES 


6   ^V  P    " 


(    A  t icj  J^^  d  Ac  ((^ 


MEMOIR 


AMOS    TWITCH  ELL,     M.D. 


AN   APPENDIX, 


CONTAINING        JI  I  S        ADDRESSES,        ETC. 


HENRY  I.  BOWDITCH,  M.D. 


BOSTON: 

PRINTED   BY  JOHN  WILSON   AND    SON 

B,  Bcuoox.  Strut. 

1851. 


Iplf- 


CONTENTS. 


P0\: 


CHAPTER    I. 

FROM  1781   TO  1797.- UNDER  17  YEARS   OF   AGE. 

Paoe 

Introduction.  Early  Ancestry.  Rev.  John  Wilson.  Father:  Early  Settler 
at  Dublin.  Library.  Mother :  her  Influence  upon  her  Son's  Destiny. 
Birth  of  Amos  Twitchell.  Mountain  Scenery  of  his  Native  Village. 
Homestead.  Early  Infancy.  Gentleness  of  Disposition.  Expertness 
at  Swimming.  Daring  Feats.  Love  of  Reading,  of  Arithmetic.  Com- 
mon Schools.  Anecdote.  New  Ipswich  Academy.  Reputation  of  the 
Lad  with  his  Comrades 1 


CHAPTER    II. 

FROM  1793   TO  1802. 2ET.  17-21. 

Starts  for  College.  Visits  Cambridge.  Rejected.  Anecdote.  Enters  Dart- 
mouth. Dartmouth  in  179S.  Professors.  Associates.  Extract  of  a 
Letter  from  Daniel  Webster.  Character  at  College.  Practical  Jokes. 
Anecdote.  Repartee  to  President  Wheelock.  Swimming.  Anecdote. 
Love  of  Mathematics.  Calculation  of  Eclipses.  Greek  Scholarship. 
Graduation.  School-teaching.  Correspondence.  Theory  of  Sudden 
Frost.    Greek  Manuscript. 14 


CHAPTER   in. 

FROM  1802   TO  1805. ^ET.   21-24. 

Early  Tendency  to  the  Study  of  Medicine.  Anxieties  on  leaving  College. 
Dr.  Nathan  Smith,  Preceptor.  Sketch  of  Dr.  Smith's  Life.  Prelimi- 
nary Education  necessary  to  the  Medical  Student.  Influence  of  Dr. 
Smith  on  Mr.  Twitchell.  Practical  Anatomy.  Obstructions  to  the 
Study  of  it.  Dissection  in  former  Times.  Sir  Astley  Cooper  on  Resur- 
rectionizing  in  England.  Dissections  in  America.  Difficulties  of  the 
Physician.    Necessary  for  him  to  brave  Public  Opinion.     Mr.  Twitchell 


812301 


IV  CONTENTS. 

as  a  Practical  Anatomist.  Dissections  should  be  legalized  in  New 
Hampshire.  Correspondence.  Lecturer  on  Anatomy.  Removal  to 
Norwich.  Mr.  Twitchell  invited  to  deliver  a  Medical  Dissertation  at 
Dartmouth  College 25 


CHAPTER    IV. 

FROM  1805   TO   1810. ^T.   24-29. 

Mother's  Death.  Correspondence  with  Dr.  Carter.  Prospects.  Despond- 
ency, relieved  by  the  Influence  of  Dr.  Smith.  Removal  to  Marlborough. 
Operation  of  tying  Carotid.  History  of  the  Subject.  Views  of  Contem- 
porary Surgeons,  Dupuytren,  Roux,  Abernethy,  Sir  Astley  Cooper,  &.c 
Several  Minds  always  work  towards  one  Discovery.  Number  of  Times 
the  Operation  had  been  performed.  General  Results.  Twitchell  to  be 
placed  in  the  first  ranks  of  Surgery  for  this  Case 54 


CHAPTER   V. 

FROM  1S10   TO  1815. ^T.  29-34. 

Removal  to  Keene.  Even  Tenor  of  Life.  Practice.  "Spotted  Fever." 
Independence  of  Twitchell.  Dislike  of  Nosologies.  Letter  from  Dr. 
Carter.  New  Hampshire  Medical  Society,  Member,  1811.  Offices  held 
by  him  during  Life.  President,  &c.  Orator.  Engagement  to  Miss 
Goodhue.  Correspondence.  Practice.  Assemblies  at  Keene.  Pupils. 
News  of  Peace.  Rejoicings.  Horseback  Rides.  Marriage,  1315.  Cha- 
racter of  Mrs.  Twitchell.  Influence  on  her  Husband.  Death,  1843. 
Effect  of  her  Death  on  Dr.  TwitcheU. 


CHAPTER    YL 

FROM  IBM   TO  IS49. ^ET.  34—68. 

Offered  a  Professorship  at  Dartmouth  College,  1819 ;  at  Vermont  Academy 
of  Medicine,  1894;  at  Castleton,  1S2G  .;  at  Bowdoin  College,  1826.  In- 
vited to  reside  at  Boston.  Trepanning  of  Tibia.  Preceded  by  Sir 
Benjamin  Brodie.  Extensive  Rides.  Dangers ;  Labors.  Circular  to 
Patients.  Letter  to  a  Young  Friend.  Temperance.  Anecdotes. 
Youths  at  the  Tavern.  Tobacco-chewing.  Farmer  and  his  Corn. 
Visit  to  Philadelphia  as  Temperance  Delegate.  Anecdote.  Tempe- 
rance Addresses  less  successful  than  his  Conversation.  Temperance 
Documents.  Politics.  Asylum  for  Insane.  American  Medical  Asso- 
ciation ;  Origin  ;  Interest  of  Dr.  Twitchell  in  its  Welfare ;  Delegate  to 
its  Meeting 


CONTENTS.  V 

CHAPTER   VII. 

FROM  1815   TO   1850. ^3T.  34-69. 

Pjlou 
Social  Qualities.  Jokes  at  the  Hotel.  Repartee  to  a  Lawyer ;  to  a  Friend. 
Intercourse  with  Medical  Associates.  Autocrat  of  Surgery.  His  Faith 
in  the  Profession.  Intercourse  with  Patients.  Roughness  at  First. 
Exquisite  Tenderness.  Behavior  in  the  Chamber  of  Death.  Kindness 
to  the  Poor.  Anecdote.  Practical  Tact.  Violence  occasionally.  Alle- 
gro and  Penseroso.  Delights  of  being  Bled.  Neuralgia  Case.  Hatred 
of  Quackery,  and  of  all  Mystery  in  the  Treatment  of  Cases.  Willing 
to  confess  Error.  His  Operations  ;  Anxiety  to  act  rightly  about  them  ; 
Calmness  while  performing  them.  Private  Hospital.  Intercourse  with 
his  Family ;  Children.    Domestic  Discipline.    Religious  Views.    .        .     108 


CHAPTER  Vin. 

FROM  1848   TO  1850. JET.  67-69. 

My  own  Acquaintance.  Personal  Appearance.  Conversations.  Instinct 
and  Reason.  ,  Medical  Chemistry.  Cure  of  Himself  by  Strict  Diet. 
Account  of  this  Case,  dictated  to  me  by  Himself.  Jocose  Man.  Anec- 
dote of  old  "  Bucephalus."  My  delightful  Reminiscences  of  him.  Lart 
Illness  and  Death 130 

CHAPTER   IX. 

Conclusion.    Outlines  of  Dr.  Twitchell's  Character 149 

APPENDIX. 

The  Influence  of  Natural  Objects  upon  the  Mind  .  ...  155 

Ligature  of  the  Common  Carotid  Artery 158 

Cases  of  Morbid  Anatomy 166 

Cases  of  Tracheotomy 172 

The  Present  Condition  of  the  Medical  Profession 183 

Fracture  of  the  Thigh-bone,  and  the  Liability  to  a  Subsequent  Deformity 

of  the  Limb 193 

Effects  of  Ardent  Spirits  on  the  Human  System 196 

Carcinomatous  Sarcoma  in  the  Muscles  of  the  Arm 198 

Lithotomy.  —  Operation  on  a  Female 202 

Effects  of  Tobacco  on  the  Human  System 204 

Observations  on  the  Effects  of  Tobacco  on  the  Human  System    .        .        .  207 

List  of  Diplomas,  &c.  held  by  Dr.  Twitchell 212 


MEMOIR. 


MEMOIR 


CHAPTER   I. 

FROM  1781  TO  1797.  —  UNDER  17  YEARS  OF  AGE. 

Introduction.  —  Early  Ancestry.  —  Rev.  John  Wilson.  —  Father  : 
Early  Settler  at  Dublin.  —  Library.  —  Mother  :  her  Influence 
upon  her  Son's  Destiny.  —  Birth  of  Amos  Twitchell.  —  Moun- 
tain Scenery  of  his  Native  Village.  —  Homestead.  —  Early 
Infancy.  —  Gentleness  of  Disposition.  —  Expertness  at  Swim- 
ming. —  Daring  Feats.  —  Love  of  Reading,  of  Arithmetic.  — 
Common  Schools.  —  Anecdote.  —  New  Ipswich  Academy.  — 
Reputation  of  the  Lad  writh  his  Comrades. 

Invited  by  the  friends  of  Dr.  Twitchell  to  prepare  a 
brief  memoir  of  him,  I  have  approached  the  under- 
taking with  reverence  and  delight.  I  have  felt 
grateful  that  those  who  loved  him,  and  knew  him 
most  intimately,  should  have  chosen  me  as  his  bio- 
grapher ;  for,  while  occupied  in  the  study  of  his 
life,  I  have  been  brought  into  immediate  commu- 
nication with  one  of  the  most  exalted  members  of 
my  profession. 

Convinced  as  I  am,  that,  to  appreciate  justly  and 
portray  clearly  the  lights  and  shadows  of  any  cha- 
racter, one  must,  to  a  greater  or  less  extent,  live  over, 
in  his  own  individual  consciousness,  the  life  of  him 
l 


INTRODUCTION. 


whom  he  would  delineate  ;  and  that  the  more  the 
writer  loses  himself  in  his  subject,  the  more  perfectly 
he  will  succeed,  —  I  have,  throughout  the  following 
pages,  endeavored  to  display  Dr.  Twitchell's  life 
and  character  exactly  as  they  were,  uninfluenced, 
if  that  be  possible,  by  any  bias  of  my  own.  It  ill 
becomes  me  to  say  aught  in  regard  to  my  own  suc- 
cess in  this  endeavor.  I  would  simply  remark,  that, 
if  a  profound  respect  for  the  mind,  and  a  heartfelt 
love  for  the  amiable  traits,  of  an  individual ;  if,  more- 
over, a  sincere  desire  to  be  truthful  in  every  minute 
particular,  to  the  faults  as  well  as  to  the  virtues  of  a 
deceased  friend  and  professional  brother,  are  quali- 
ties which  are  useful  in  such  an  undertaking,  I  know 
that  I  may  claim  them.  My  admiration  for  the  origi- 
nal gifts  of  Dr.  Twitchell's  mind  and  heart  is  un- 
bounded. I  regard  him  as  second  in  surgical  acu- 
men to  no  man  I  have  ever  seen,  and  as  perhaps 
the  most  original  mind  our  profession  has  produced 
during  the  present  generation  in  New  England. 
Yet  he  had  his  failings,  which  I  have  endeavored  to 
look  at  dispassionately.  I  would  describe,  as  I  be- 
lieve him  to  have  been,  a  noble  specimen  of  humanity ; 
although  his  life,  like  that  of  every  other  mortal,  was 
not  altogether  blameless. 

The  data  upon  which  I  shall  rest  have  been  ob- 
tained from  many  sources.  I  have  corresponded 
with  all  who,  in  different  parts  of  our  country,  knew 
him  intimately  ;  I  have  had  personal  interviews  with 
some.  In  the  course  of  the  narrative,  I  shall  occasion- 
ally introduce  extracts  from  some  of  his  letters,  a  very 
few  of  which  remain  :  in  fact,  he  wrote  but  few.     I 


ANCESTRY.  o 

take  this  occasion  to  thank  my  correspondents  for 
the  alacrity  with  which  they  have  endeavored  to  en- 
able me  to  form  a  just  estimate  of  his  character.  But, 
for  the  main  features  of  his  mind  and  disposition,  I 
rely  very  much  upon  what  I  myself  learned  of  them 
during  several  interviews  it  was  my  good  fortune  to 
have  with  him,  subsequently  to  the  summer  of  1844, 
until  his  death.  Never  shall  I  forget  those  social, 
happy  hours  that  I  spent  in  his  society,  listening  to 
the  graphic,  but  most  child-like,  descriptions  of 
his  feats  in  operative  surgery  and  medical  practice. 
How  like  a  giant  he  seemed  to  wield  the  most  ad- 
verse circumstances,  and  make  them  bend  before 
his  power,  where  even  strong  men  would  have  been 
overwhelmed  !  How  inimitable  his  conversational 
powers  !  How  infinitely  amusing  his  sallies  of  good 
humor,  arising  from  his  keen  sense  of  the  ridiculous  ! 
How  withering  his  scorn  of  hypocrisy  and  pre- 
tence !     How  glorious  his  love  of  truth  ! 

God  grant  that  what  I  shall  say  may  be  strictly 
true  !  I  write  with  the  feeling  that  his  disembodied 
spirit  is  ever  before  me  ;  and  I  have  always  be- 
lieved, that  in  no  way  could  I  give  greater  offence 
to  that  great  soul  than  by  any  unmerited  or  indis- 
criminate praise.  I  fear  that  a  few  passages  may 
cause  sorrow  to  some  whom  I  love  and  respect.  If 
it  should  be  so,  I  shall  deeply  regret  it  ;  but  I  know 
not  how  I  could  write  otherwise,  and  be  faithful  to 
the  complete  history  of  his  life. 

I  can  learn  but  little  of  the  early  paternal  ancestry 
of  Dr.  Twilchell.  His  grandfather,  Capt.  Joseph 
Twitchell,  was  born  Feb.  13,  1719.     He  lived  at 


4  FATHER. 

Sherburne,  and  died  March  12,  1793.  By  his  mo- 
ther's side,  he  was  a  lineal  descendant  of  the  Rev. 
John  Wilson,  a  man  famed  in  story,  and  whom 
Cotton  Mather*  styles  "the  father  to  the  infant  co- 
lonies of  New  England."  Mr.  Wilson  arrived  from 
England  in  1630.  From  him  descended,  in  regu- 
lar succession,  as  many  worthy  pastors  as  there 
were  generations,  until  the  maternal  grandfather  of 
Twitchell  entered  upon  life.  Forsaking  the  holy 
office  of  his  ancestors,  he  assumed  the  equally  sacred 
one  of  medicine.  In  the  eyes  of  the  pious  of  those 
days,  he  was,  however,  believed  to  have  brought 
evil  upon  himself  by  so  doing.  He  practised  me- 
dicine at  Sherburne,  where  he  died  in  early  life ; 
leaving  a  widow  and  an  infant  daughter,  named 
Alice,  the  mother  of  Dr.  Twitchell ;  so  that,  through 
her,  the  destined  autocrat  in  surgery  in  New  Hamp- 
shire received  the  united  mantles  of  New  England 
theology  and  physic.  Of  theology  he  adopted  all 
that  is  contained  in  the  resolution  made,  two  hundred 
and  thirty  years  ago,  by  his  great  progenitor,  viz.  : 
"  to  be  content,  if  the  Lord  would  grant  him  liberty 
of  conscience  and  purity  of  worship."  Over  the 
domains  of  physic  he  was  destined  to  shed  new 
lustre,  by  his  admirable  intellect  and  sound  common 
sense. 

Samuel  Twitchell,  father  of  Dr.  Twitchell,  was 
born  at  Sherburne,  [Massachusetts,  in  1740.  He  be- 
came one  of  the  earliest  of  the  settlers  at  Dublin, 
New  Hampshire,  where  he  died,  April  16,  1S20, 
after  his  son  had  risen  to  fame.      When  he  went 

*  Magnalia,  chap.  iii.  book  iii.  Wilsonia. 


FATHER.  0 

thither,  there  were  only  twelve  families  in  the  place. 
I  learn  from  one  who  knew  him  intimately,  that  he 
was  a  man  of  an  active  mind,  though  of  the  limited 
education  of  that  period.  He  was,  however,  fond 
of  reading  and  of  conversing  with  men  of  superior 
attainments,  and,  of  course,  was  intimate  with  the 
neighboring  clergymen.  He  was  a  rigid  Calvinist 
in  early  life ;  but  he  subsequently  became  a  Resto- 
rationist,  and  too  liberal  in  his  views  of  religious 
matters  to  meet  wholly  the  approbation  of  the  clergy. 
He  was  foremost  to  interest  himself  in  the  subject  of 
establishing  town-libraries  in  that  section  of  the  coun- 
try. In  the  year  1793,  one  was  founded  in  Dublin  ; 
and  Mr.  Twitchell,  at  that  time  a  member  of  the 
legislature,  procured  for  it  a  charter.  His  name 
is  second  on  the  list  of  applicants  for  the  charter. 
He  presided  at  the  first  meeting  under  the  act  of 
the  legislature,  and  afterwards  became  one  of  the 
committee  for  the  choice  of  books.  He  was  fond  of 
the  society  of  the  young,  particularly  of  the  more 
educated  class.  Hence  young  teachers  and  col- 
legians were  especial  favorites.  For  a  time  he  had 
a  private  governess  in  his  family. 

He  used  frequently  to  take  his  son  Amos,  the 
subject  of  this  memoir,  with  his  brothers  to  town- 
meetings  ;  thus  early  training  them  to  their  duties  of 
citizenship.  In  those  days,  intemperance  held  its  full 
sway,  and  no  election  took  place  without  an  enter- 
tainment to  the  voters  being  given  by  the  candidates. 
This  custom  Mr.  T.  strongly  opposed,  as  being  in- 
consistent with  genuine  liberty  and  morality.  From 
his  lips  occasionally  fell  maxims,  which  were  not 
l* 


MOTHER. 


lost  by  his  young  hearers.  Alluding  to  a  person 
who  would  buy  a  vote,  he  remarked,  "  A  man  who 
will  buy  a  vote  will  likewise  sell  one."  "  Better 
suffer  wrong  than  do  wrong,"  &c. 

He  was  much  beloved  by  his  fellow-townsmen. 
It  has  been  said  that  he  had  not  an  enemy.  He  was 
at  one  lime  a  magistrate,  and,  during  the  revo- 
lutionary war,  was  commander  of  a  company  of 
minute-men.  In  addition  to  all,  and  probably,  it 
may  be  said,  before  all  these  occupations  I  have 
named,  he  was  a  substantial  farmer  and  miller. 
But  he  was  poor,  and  would  therefore  have  been 
well  satisfied  if  his  son  could  have  been  willing 
to  settle  down  on  his  own  paternal  acres,  and  follow 
the  honorable  calling  of  tiller  of  the  soil,  with  an 
occasional  superintendence  of  the  mill.  In  fact, 
it  was  not  until  dire  experience  had  proved  that  it 
would  be  profitless  to  try  to  make  an  alter  ego  of 
his  son,  that  he  freely  gave  him  scope  to  pursue  the 
natural  tendencies  of  his  own  genius.  Dr.  Twit- 
chell,  though  he  esteemed  his  father,  rarely  spoke 
of  him  with  that  high  reverence  and  regard  which 
he  evinced  when  he  alluded  to  his  mother. 

This  most  excellent  woman  was  the  daughter,  as 
we  have  already  stated,  of  Dr.  Wilson,  of  Sherburne. 
She  was  married  to  Mr.  Twitchell,  Feb.  9,  1766. 
They  had  nine  children,  and  Amos  was  the  seventh. 
She  was  a  strong-minded  woman,  of  very  domestic 
habits,  and  of  a  kind  and  affectionate  disposition. 
Admirable  in  her  social  qualities,  she  was  a  thought- 
ful neighbor  and  a  practical  Christian.  She  has  been 
famed  for  her  qualities  as  a  nurse  to  her  sick  friends, 


MOTHER.  7 

although  entirely  free  from  any  "  old  woman's  quack- 
ery." #  Fond  as  she  was  of  reading,  her  domestic 
avocations  prevented  her  from  enjoying  that  relaxa- 
tion, except  when  her  husband  or  some  of  her  chil- 
dren were  able  to  read  aloud  to  her.  This  Amos 
was  wont  to  do,  from  his  earliest  years.  She  seems 
to  have  fully  appreciated  the  fine  qualities  of  her  son, 
and  to  have  determined,  though  struggling  with  po- 
verty and  surrounded  by  a  numerous  family,  each 
one  of  whom  claimed  and  received  her  maternal  care, 
he  nevertheless  should  have  the  best  education  that 
could  be  obtained.  Dr.  Twitchell  used  to  say, 
that  to  her  energy  he  owed  his  college-course  ; 
for  his  mother  never  swerved  from  the  determina- 
tion she  made,  that,  whatever  else  might  happen,  he 
should  receive  a  college-education. 

As  an  evidence  of  the  untiring  energy  of  this 
worthy  mother,  he  was  wont  playfully  to  say,  that, 
when  he  entered  college,  his  coat  had  been  almost 
wholly  renewed  by  her  earnest  and  efficient  needle- 
work. This  little  incident,  homely  though  it  may 
be  in  the  eyes  of  some,  speaks  volumes  to  me  in 
her  behalf. 

In  her  religious  opinions,  Mrs.  Twitchell  was  or- 
thodox ;  but  evidently  she  thought  for  herself,  and 
her  tendencies  were  to  liberal  views  of  Christianity. 
On  one  occasion  she  did  not  allow  her  children  to  go 

*  In  fact,  there  being  no  physician  near,  she  was  consulted  on 
all  occasions  of  sickness  in  the  village,  and,  not  unfrequently,  was 
called  from  domestic  pursuits  to  go  to  see  distant  friends,  to  whom 
her  practical  common  sense  was  often  of  inestimable  value,  in  a 
medical  point  of  view. 


6  BIRTHPLACE. 

to  sabbath  school;  and,  upon  being  questioned  on 
the  subject  by  Father  Sprague,  the  clergyman  of  the 
village,  she  replied  that  she  did  not  allow  her  chil- 
dren to  study  the  Westminster  Catechism,  which 
contained  many  things  that  she  did  not  believe  in. 
In  the  future  course  of  this  history,  I  think  we  shall 
be  able  to  trace  the  impress  of  parental  influence  in 
some  of  the  peculiar  traits  of  character  evinced  by 
Dr.  Twitchell. 

Amos  Twitchell  was  born  April  14,  1781.  Dub- 
lin, his  native  town,  is  beautifully  situated  among  the 
hills,  in  the  southern  part  of  New  Hampshire.  Its 
ancient  church,  built  by  its  earliest  settlers,  still 
crowns  the  summit  which  divides  the  fertile  valley  of 
the  Connecticut  from  those  of  the  Coontocook  and 
Merrimack.  On  a  fair  Sabbath  morning,  the  vil- 
lagers, when  collected  for  divine  worship,  could  see 
afar  off,  in  the  west,  the  Green  Mountains,  skirting 
the  horizon  with  their  shadowy  outlines,  while  close  at 
hand  arose  to  their  view  the  hoary-headed  "  Moun- 
tain of  the  Great  Spirit."*  To  the  east,  the  eye 
could  grasp  twenty  or  thirty  miles  of  the  valley  of  the 
Contoocook,  with  its  pellucid  stream  rolling  onward 
to  swell  the  waters  of  the  Merrimack. 

Resting  on  a  gentle  slope,  about  three  miles  from 
the  summit  we  have  just  spoken  of,  stood  the  substan- 
tial square-built  house  of  young  TwitchelPs  father.  It 

*  Mr.  S.  G.  Drake,  well  known  for  his  archaeological  researches, 
more  especially  for  his  learning  upon  every  subject  relative  to  the 
Indians,  informs  me  that  this  is  the  signification  of  Monadnock, 
or  Monadnook. 


CHILDHOOD.  9 

was  fairly  embosomed  in  a  fertile  valley ;  but  from 
many  parts  of  the  extensive  farm  could  the  youth 
have  a  view  similar  to  that  which  I  have  attempted  to 
describe,  as  plainly  visible  from  the  highest  spot  of  the 
village.  It  was  here,  that,  when  a  child,  he  learned 
to  love  the  hills,  and  gained  with  them  that  fellow- 
feeling,  which,  in  after-life,  caused  them  always  to 
exert  over  him  their  divinest  influences. 

On  the  stream,  about  thirty  rods  from  the  house, 
stood  the  small  mill  owned  by  his  father.  The  vil- 
lage-school was  a  mile  off.  Nothing  remains  now 
to  mark  these  places,  save  the  huge  willow-trees, 
which,  if  tradition  says  true,  were  planted  by  young 
Twitchell  in  front  of  his  father's  homestead.  Instead 
of  the  old  places  have  arisen  a  modern  house  and  a 
more  commodious  mill.  Nature,  however,  still  re- 
tains her  loveliness,  amidst  all  the  changes  wrought 
by  man ;  and  one  can  see  at  a  glance,  that  a  moun- 
taineer's freedom  of  thought,  and  a  hill-side  species 
of  worship,  might  naturally  have  been  aroused  in  the 
boy's  soul,  from  its  earliest  years. 

Amos  was  weak  and  puny  at  his  birth,  fragile 
during  infancy;  and,  as  his  parents  had  previously 
lost  several  children  in  early  infancy,  he  was,  of 
course,  guarded  with  every  solicitude.  From  a  very 
early  age  he  was  remarkable  for  the  extreme  tender- 
ness of  his  heart.  He  could  not  bear  to  see  any  animal 
killed,  and  was  distressed  at  seeing  a  cat  torturing  a 
mouse.  Hence  it  has  been  a  marvel  to  some,  that  he 
ever  was  able  in  after-life  to  amputate  a  limb  from  a 
human  body,  apparently  with  the  most  perfect  cool- 
ness.    The  remark  has  been    made,  of  course,  by 


10  LOVE    OF    READING. 

persons  unacquainted  with  the  philosophy  upon 
which  is  grounded  the  practice  of  surgery. 

As  the  boy  grew  up,  he  became  more  robust,  and 
delighted  in  manly  exercises.  As  a  swimmer,  he 
was  unequalled.  His  daring  exploits  in  this  parti- 
cular are  yet  the  theme  of  admiration  for  all  who 
remember  him.  One  correspondent  tells  me,  that,  a 
little  later  in  life,  he  not  unfrequently  went  two 
miles,  for  the  purpose  of  diving  from  a  bridge  thirty 
feet  high,  and,  a  still  greater  distance,  to  a  mill-pond, 
where,  from  a  lofty  bank,  he  could  dive  to  the 
bottom,  which  was  many  feet  deep. 

From  one  who  was  a  resident  in  the  family,  when 
he  was  about  six  years  of  age,  I  learn  that  even 
at  this  time  he  was  fond  of  books.  As  he  grew 
older,  this  love  of  reading  augmented,  and  he  es- 
pecially delighted  in  history,  voyages,  and  travels. 
Of  the  few  books  he  could  obtain,  the  Arabian 
Nights'  Entertainments  were,  as  they  have  been  to  so 
many  others  before  and  since,  a  never-failing  resource. 
Sir  Charles  Grandison  was  a  great  favorite.  A 
certain  Dictionary  of  Arts  and  Sciences  is  also  re- 
membered as  a  work  which  he  used  to  pore  over  with 
delight.  He  early  became  one  of  the  subscribers  to 
the  Dublin  Library. 

A  liking  for  the  study  of  arithmetic  was  likewise 
soon  observable.  The  common  schools  at  that  time 
were,  throughout  the  country,  in  a  very  low  con- 
dition. How  much  more  so  must  it  have  been  in 
this  newly  settled  village  !  # 

*  How  different  now,  when,  if  fame  says  truly,  Dublin  is  a 
light   to  the  towns  around  for  the   excellence  of  her  common 


YOUTH.  11 

He  attended  school,  about  four  months  in  a  year, 
until  the  age  of  fourteen,  when  the  following  in- 
cidents took  place,  which  induced  his  father  no 
longer  to  oppose  his  inclination  to  go  to  college. 

It  was  a  fair  day,  towards  the  middle  of  the  hay- 
ing season  of  1797.  All  the  able-bodied  men  upon 
the  farm  were  fully  occupied  in  the  field,  and  young 
Amos  was  ordered  by  his  father  to  superintend  the 
mill.  A  neighbor  arrived  with  his  sack  of  corn,  and 
left  it  under  the  care  of  the  boy.  Into  the  hopper 
the  grain  was  thrown  ;  the  wheels  soon  began  to  whirl, 
and  the  mill-stones  to  pour  down  the  meal ;  but, 
unfortunately  for  the  worthy  father,  the  boy  had 
procured,  a  short  time  before,  a  book  on  arithmetic, 
and  soon  his  mind  was  in  the  region  of  abstraction. 
How  long  he  continued  so,  he  could  not  and  cared 
not  to  tell ;  but  the  grist  was  finished,  and  still  the 
stones  whirled  around.  Wholly  absorbed  in  his 
mental  operations,  Amos  neglected  every  thing  else; 
thus  bringing  infinite  injury  to  the  unfortunate  mill- 
er's property. 

A  similar  accident  soon  afterwards  occurring,  and 
by  which  a  quantity  of  flaxseed  was  spoiled,  con- 
vinced the  father,  that,  as  a  matter  of  economy,  if  for 
no  other  reason,  it  would  be  far  better  not  to  employ 

schools  !  All  honor  to  the  two  clergymen  to  whom  chiefly  this 
change  is  due  !  To  Father  Sprague  we  would  give  praise  for  his 
wise  philanthropy  and  practical  sagacity,  in  leaving  a  fund  to  the 
town  for  the  support  of  common  schools.  And  to  his  Oberlin-like 
successor  is  due  more  than  can  be  expressed ;  for,  by  his  well- 
balanced  and  admirably  cultivated  mind,  his  indefatigable,  quiet 
enthusiasm,  his  catholic  spirit  and  gentle  manners,  he  has  led  his 
fellow- townsmen  duly  to  value  the  privileges  spread  before  them. 


12 


NEW     IPSWICH    ACADEMY. 


his  son  upon  labor  unsuited  to  his  disposition.  Ac- 
cordingly, on  the  morning  after  this  last  accident,  the 
little  bundle,  tied  up  in  the  checked  handkerchief, 
long  afterwards  remembered,  was  ready  for  him,  and 
greeted  his  eyes  on  first  rising.  His  father  was 
there  with  it,  and  cordially  bade  him  God  speed  to 
school,  as  he  could  not  afford  to  keep  him  at  home 
any  longer. 

He  immediately  entered  New  Ipswich  Academy, 
then  under  the  care  of  the  Rev.  Samuel  Worcester, 
who  was  afterwards  settled  over  the  Congregational 
Church  in  Salem,  Mass. 

It  has  been  my  good  fortune  to  meet  with  two 
who  were  his  school-mates  while  at  New  Ipswich, 
and  have  been  ever  since  among  his  most  inti- 
mate personal  friends.  By  them  I  learn,  that  young 
Twitchell  was  of  a  large,  imposing  frame,  both  of 
body  and  mind ;  and  that  he  was  universally  con- 
sidered one  of  the  most  ingenuous,  noble-hearted, 
and  intelligent  boys  of  the  school.  Of  all  those  who 
were  at  that  time  at  school,  no  one  retained  as  a 
man  so  entirely  the  peculiarities  of  the  boy.  Upon 
the  form  he  was  quick  and  active,  rather  than  a  hard 
student.  He  saw  rapidly  through  the  intricacies  of 
a  lesson,  especially  in  mathematics  ;  and,  to  fill  up  his 
leisure  time,  his  wit  and  love  of  fun  were  amply 
adequate.  Abusive,  obscene,  or  profane  words 
rarely,  if  ever,  escaped  his  lips.  He  was,  in  fact,  the 
general  favorite  of  the  school,  equally  respected  and 
beloved  by  his  mates,  whether  as  a  jocose,  hearty, 
robust  football  player,  or  as  a  scholar  of  the  first 
rank. 


NEW    IPSWICH    ACADEMY.  13 

He  remained  at  New  Ipswich  about  seven  or 
eight  months,  was  subsequently  with  the  Rev.  Mr, 
Palmer,  of  Townsend,  and  finally  was  prepared  to 
enter  college. 


14 


CHAPTER   II. 


FROM   1798   TO   1802.  JET.   17—21. 


Starts  for  College.  —  Visits  Cambridge.  —  Rejected.  —  Anecdote. 
—  Enters  Dartmouth.  —  Dartmouth  in  1798.  —  Professors.  — 
Associates.  —  Extract  of  a  Letter  from  Daniel  Webster.  — 
Character  at  College.  —  Practical  Jokes.  —  Anecdote.  —  Re- 
partee to  President  "SVheelock.  —  Swimming.  —  Anecdote.  — 
Love  of  Mathematics.  —  Calculation  of  Eclipses.  —  Greek 
Scholarship.  —  Graduation.  —  School-teaching.  —  Correspond- 
ence. —  Theory  of  Sudden  Frost.  —  Greek  Manuscript. 

The  time  had  now  arrived  for  Mr.  Twitchell  to  enter 
college.  In  those  days,  regular  stage-coaches  were 
unknown  at  Dublin.  Mounted  on  a  good  country 
farm-horse,  and  with  his  saddle-bags  on  each  side, 

he  and  his  friend  G commenced  their  journey 

towards  Boston,  with  the  intention  of  entering  Har- 
vard University.  It  was  about  the  middle  of  the 
month  of  August,  in  1798. 

The  youth  was  just  at  the  golden  age  of  seven- 
teen. Gaily  did  he  pursue  his  course,  and,  arriving 
at  our  venerable  Alma  Mater,  demanded  admission. 
But  her  portals  were  not  destined  to  open  at  his 
request.  He  was  refused  admittance,  on  the  ground 
that  he  had  not  studied  all  the  books  required  for 
admission  to  Harvard. 

Upon   hearing  the  decision  in  regard  to  himself, 


DARTMOUTH    COLLEGE.  15 

he  jocosely  remarked  to  his  chum  that  was  to  be, 
as  if  nothing  had  happened,  "  Oh  !  it  is  of  very  little 
importance.  As  I  was  coming  to  visit  Boston,  I 
thought  I  would  just  step  out  and  see  Cambridge. 
I  have  seen  it ;  and,  if  I  cannot  slay  here,  it  is  of  no 
consequence  whatever  ;  for  I'll  go  elsewhere."  Suit- 
ing the  action  to  the  word,  he  again  mounted  his 
horse,  turned  his  head  northward,  and,  with  a 
cheerful,  merry  heart,  rode  on  steadily  towards  Han- 
over. This  institution  received  him,  and  thereby 
gained  one  of  the  most  remarkable  of  her  many 
sons;  while  Harvard  lost  the  opportunity  of  en- 
rolling upon  her  list  one  of  the  most  honest  and 
intellectual  men  this  country  has  produced. 

Dartmouth  in  1798  !  How  shall  we  describe  it  ? 
Twenty-seven  years  before,  its  royal  charter  had 
been  given  at  the  instance  of  the  earnest  and  pious 
Dr.  Eleazer  Wheelock,  who  for  many  years  had 
been  laboring,  with  the  zeal  of  an  apostle,  for  the 
conversion  of  the  Indian  tribes,  that  at  that  time  still 
flourished  among  the  woods  of  northern  New  Hamp- 
shire. Chiefly  for  the  civilization  of  the  red  man, 
and  incidentally  only  to  "  promote  learning  among 
the  English,"  did  King  George  III.  grant,  in  1769, 
to  William,  Earl  of  Dartmouth,  and  his  associates, 
the  vested  rights  of  trusteeship,  which  have  de- 
scended to  the  present  time.  In  1771  the  first  class 
of  four  persons  was  graduated  ;  and  among  them 
was  he  who  presided  with  so  much  sagacity  over 
the  college  at  the  time  Twitchell  entered  it,  viz.  the 
Rev.  John  Wheelock,  son  of  the  pious  founder  of 
the  institution. 


16  COLLEGE    JOKES. 

By  the  side  of  Dr.  Wheelock,  in  the  government 
of  the  college,  were  the  Rev.  Drs.  ShurtlefF  and 
Smith ;  the  latter,  Professor  of  Latin  and  Greek 
literature.  Nathan  Smith  also  was  just  commencing 
his  brilliant  career,  as  the  founder  of  the  Medical 
School  at  Hanover,  which  now  holds  so  high  a  rank. 
This  gentleman,  as  we  shall  hereafter  see,  was  des- 
tined to  have  great  influence  in  the  moulding  of 
young  Twitchell's  mind. 

Among  Mr.  Twitchell's  associates  at  college,  stand 
recorded  some  of  the  most  eminent  of  our  land. 
James  Dean,  long  Professor  of  Mathematics  at 
Montpelier,  was  in  the  junior,  Hon.  Daniel  Webster 
in  the  sophomore  class,  when  Twitchell  entered. 
Hon.  Henry  Hubbard,  Drs.  Mussey  and  Shattuck, 
were  graduated  in  the  class  after  him.  With  many 
of  these,  he  retained,  during  his  whole  life,  a  most 
uninterrupted  and  generous  friendship.  Daniel  Web- 
ster writes  to  me  in  reference  to  Dr.  T.,  under  date  of 
July  8,  1850 ;  and,  after  alluding  in  the  highest  terms 
to  his  intellectual  vigor,  he  says,  "  Having  always 
maintained  with  him  relations  of  personal  friendship 
and  kindness,  I  felt  his  loss  as  an  affliction  to  myself." 

While  at  college,  he  retained  the  same  character 
that  he  had  gained  at  school,  of  open-hearted  frank- 
ness, and  love  of  fun,  which  either  broke  out  in  prac- 
tical college-jokes,  or  expended  itself  in  humorous 
stories,  some  of  which  certainly  approached  the 
confines  of  pure  wit.  If  any  prank  peculiarly  bold 
had  been  played,  suspicion  immediately  fell  on  Twit- 
chell, as  having,  either  directly  or  indirectly,  some 
knowledge  of  it.    He,  however,  always  escaped  from 


ANECDOTE.  17 

being  brought  into  real  disgrace  with  the  college- 
government  ;  for  his  jokes  had  no  character  of  mean- 
ness or  malice  about  them.  They  were  simply  the 
innocent  outpourings  of  an  exuberant  and  boyish 
nature  ;  and,  as  youth  passed  away,  they  left  no 
stain  upon  him,  for  the  energy  that  directed  them 
was  turned  to  higher  aims.  At  times,  however,  his 
boldness  before  the  government  took  almost  the  as- 
pect of  impertinence ;  and,  had  it  not  been  for  the 
Hudibrastic  absurdity  and  daring  fearlessness  of  his 
replies,  he  might  have  met  with  severe  rebuke.  The 
following  well-known  and  oft-repeated  story  has 
been  frequently  told  to  me  by  his  friends ;  and  it  was 
evident  that  he  enjoyed  with  infinite  glee  the  remini- 
scence of  the  scene.  A  very  grave  offence  had  been 
committed  by  some  one ;  the  dignity  of  the  parietal 
government  of  the  infant  college  had  been  sorely  set 
at  defiance ;  for,  at  the  morning  summons  to  prayers, 
strange  sounds  had  issued  from  the  belfry.  Instead 
of  the  musical  notes  of  the  college-bell,  sounding  like 
the  sacred  convent-bells  of  the  old  world,  at  early 
dawn,  and  summoning  every  sleeper  to  matins,  arose 
plaintive  sounds,  as  if  the  whole  contents  of  a  sheep- 
fold  had  been  suddenly  transferred  to  the  top  of  the 
college  chapel.  Significant  glances  stole  about 
among  the  students.  President  Wheelock  looked 
grave.  With  each  swing  of  the  bell,  the  sounds  of 
woe  arose,  more  and  more  earnestly,  upon  the  still 
morning  air,  and  floated  over  the  neighboring  hills. 
The  solemn  services  of  the  day  were,  doubtless,  some- 
what interfered  with  ;  and  a  conclave  of  the  faculty 
was  held  to  bestow  condign  punishment  upon  the 


18  COLLEGE    LIFE. 

offender,  who  had  been  so  daring  as  absolutely  to 
drag  up  into  that  narrow  and  lofty  spot  a  "  patriarch 
of  the  flock"  of  sheep,  belonging  to  a  neighboring 
farmer.  Twitchell,  as  usual,  was  thought  to  know 
all  about  the  matter.  It  does  not  appear,  however, 
that  he  was  really  the  author  of  the  scheme.  Dr. 
Wheelock,  as  tradition  informs  me,  was  very  keen 
and  lawyer-like  in  cross-questioning  the  students ;  so 
that  he  rather  prided  himself  on  his  ability  to  dis- 
cover all  offenders  against  the  true  honor  of  Dart- 
mouth. On  this  occasion,  however,  he  may,  like 
some  advocates,  have  overstepped  those  bounds 
which  are  laid  down  to  govern  individuals  in  their 
intercourse  with  other  men.  I  do  not  mean  to  say 
that  Dr.  Wheelock  did  any  thing  improper ;  but 
simply,  that,  in  questioning  Twitchell,  he  made  some 
very  home,  and  probably  uncalled-for  thrusts.  Twit- 
chell parried  them  for  some  time :  at  length  the 
president  said  abruptly,  "  Well !  but,  Twitchell,  how 
do  you  suppose  that  ram  got  into  the  belfry  ?  You 
certainly  have  some  notion  about  the  matter.  Give 
us  your  opinion,  sir." 

Those  of  us  wTho  knew  Twitchell  in  after-life  can 
well  imagine  the  twinkle  of  the  eye  and  the  internal 
chuckle  with  which  he  solemnly  answered  as  fol- 
lows :  "  Well,  sir !  as  I  was  passing  the  chapel  this 
morning,  I  observed  some  peculiar  marks  upon  the 
wall  near  the  lightning  rod.  Perhaps  he  climbed 
up  that  way  ! "  All  this  was  said,  of  course,  with 
a  becoming  gravity  of  manner,  quite  in  accordance 
with  the  circle  of  grave  faces  in  whose  presence 
he  stood.     The  very  boldness,  combined  with  the 


COLLEGE    LIFE.  19 

grotesqueness  of  the  idea,  saved  the  youth  from 
further  questioning,  and  he  was  dismissed  even  with 
a  smile  ;  dignity  evidently  yielding  to  the  genuine 
impulse  of  nature. 

Many  a  year  afterwards,  Dr.  Twitchell  related  to 
me  the  following  practical  joke,  which  he  played 
upon  his  companions.  He  was,  as  we  stated,  a  most 
excellent  swimmer,  and  had  accustomed  himself  to 
dive  and  remain  for  a  long  while  under  water.  Soon 
after  he  entered  the  college,  he  went  out  to  bathe 
with  his  companions  in  a  neighboring  stream.  He 
found  that  it  was  thought  a  great  feat  to  swim  across 
to  a  certain  island  ;  and,  as  some  of  them  were  boast- 
ing very  much  of  their  great  powers  in  this  respect, 
he  determined  to  humble  them,  and  crack  a  joke  at 
the  expense  of  all.  He  delayed  until  his  compa- 
nions had  commenced  bathing,  and  then  pretended 
to  ask  advice  about  the  process  ;  as  to  how  he 
should  move  his  limbs,  and  whether  it  would  be  dan- 
gerous for  one  who  did  not  know  how  to  swim,  to 
jump  off  where  the  water  was  several  feet  deep. 
He  submitted  to  the  jeers  of  the  youths,  and  finally, 
contrary  to  their  advice,  jumped  off  into  the  rushing 
stream.  The  moment  he  arrived  below  the  surface 
of  the  water,  he  turned  his  head  towards  the  down- 
ward current,  and  went  rapidly  along  beneath  the 
surface.  As  he  arose  to  breathe,  he  floated  in  silence 
down  the  stream,  unseen  by  any  one.  It  was  about 
twilight  in  the  evening,  and  he  was  soon  out  of  sight 
of  his  comrades.  He  then  landed,  and  concealed 
himself  among  the  bushes.  Here  he  remained, 
highly   amused  at  the  dismay   of  his   schoolmates, 


20  COLLEGE    LIFE. 

who,  after  calling  for  him  in  vain,  hastily  dressed 
themselves,  and  prepared  to  arouse  the  neighborhood 
in  order  to  drag  the  river.  When  he  had  sufficiently 
enjoyed  himself  at  their  expense,  and  just  as  they 
were  starting  in  pursuit  of  their  elders,  Twitchell 
called  out  to  them,  and  quietly  asked  where  they 
were  going,  and  why  they  were  "  making  so  much 
fuss"! 

But  Twitchell  was  not  a  joker  merely  when  in 
college;  and,  although  he  was  at  times  a  source 
of  vexation  to  his  superiors,  he  always  commanded 
their  respect  for  his  honesty,  his  pure  morality,  his 
strong  intellect,  and  high  scholarship.  He  wasted  not 
his  hours,  but  devoted  himself  especially  to  mathe- 
matics, and  likewise  made  himself  a  proficient  in  the 
classics.  He  calculated  the  elements  of  the  total 
eclipse  of  the  sun  in  1806.  With  the  assistance  of  a 
friend,  he  prepared  an  almanac.  From  this  friend, 
I  learn  that  he  stood  very  high  as  a  Greek  scholar, 
and  that  the  Greek  Oration,  which  was  assigned  to 
him  at  Commencement,  was  considered  among  the 
first  four  parts.  It  was  a  common  remark  among  his 
fellow-students,  that  his  organs  of  voice  seemed  pe- 
culiarly fitted  for  the  pronunciation  of  that  sonorous 
language,  so  that  it  was  a  great  pleasure  to  hear  him 
read  or  speak  it. 

Dr.  Twitchell  was  graduated  in  1802.  During 
the  whole  period  of  his  pupilage,  he  had  been  strug- 
gling with  poverty.  This  had  made  it  necessary  for 
him  to  keep  school  for  support  during  the  winter. 
Accordingly,  he  had  taken  charge  of  district  schools 
in  Rockingham,  Marlborough,  Dublin,  and  perhaps 


COLLEGE    CORRESPONDENCE.  21 

other  places.  Some  of  his  pupils  are  still  alive  ;  and, 
from  their  account,  I  infer  that  he  combined,  in  a 
remarkable  degree,  a  power  of  government  with  an 
unusual  degree  of  familiarity  with  his  pupils.  The 
one,  howrever,  never  encroached  on  the  other.  He 
had  sagacity  enough  to  prevent  that  catastrophe. 

The  following  extracts  from  some  of  his  letters 
will  afford  a  faint  idea  of  the  young  man  and  of  his 
pursuits  during  his  college-life.  It  can,  I  would 
premise,  be  safely  said  that  letter-writing  was  never 
his  forte. 

"  Dartmouth  College,  April  4,  1800. 

"  Friend  ***,  —  The  perusal  of  your  letter  led  me 
into  an  agreeable  train  of  reflections.  I  hoped  for  the 
perusal  of  another  before  this  time.  Wednesday  last  was 
the  day  of  our  Sophomorial  Exhibition,  on  which  I  had 
the  honor  of  pronouncing  the  Greek  Oration,  on  the  account 
of  which  I  have  been  unable  to  write  ;  but,  if  health  per- 
mit, I  expect  I  shall  have  it  in  my  power  to  write  oftener. 
It  is  very  unhealthy  this  spring  in  college.  Fevers  rage 
among  the  students  to  such  a  degree  that  it  is  very 
gloomy  indeed ;  .  .  .  .  and  now,  instead  of  being  decked 
with  the  garlands  of  May,  I  am  clad  in  the  weeds  of 
mourning  for  a  brother  classmate.  ...  I  sent,  by  last 
mail,  for  the  paper  which  is  printed  in  Keene ;  and  I  hope 
I  shall  have  the  pleasure  of  perusing  some  of  the  produc- 
tions of  your  fertile  genius  through  that  medium 

Yours  affectionately,  Amos  Twitchell. 

"Dr.  Carter." 

The  following  indicates  that  he  had  already  se- 
lected his  profession.     As  a  junior  under-graduate, 


22  COLLEGE    CORRESPONDENCE. 

he  is  attending  with  interest  upon  Dr.  Nathan  Smith's 
lectures. 

"Dartmouth  College,  Oct.  28,  1801. 

"  Respected  Friend,  —  ...  Having  had  my  time,  since 
my  arrival,  principally  taken  up  with  Dr.  Smith's  lectures, 
I  have  had  no  leisure  for  writing.  .  .  . 

"  With  regard  to  a  school,  I  have  heard  nothing  from 
Esquire  Sweetser,  so  I  conclude  he  does  not  expect  to 
employ  me.  I  have  not  yet  engaged  one ;  but  I  have 
some  prospect  of  one  at  Westminster,  Mass."  .  .  . 

Under  date  of  June  14,  1S01,  he  writes  thus,  after 
alluding  to  his  delight  at  receiving  a  letter  from  Dr. 
Carter  :  — 

"  We  have  been  favoured  with  a  beautiful  season, 
although  on  the  seventh  instant  we  had  a  very  cold  day, 
attended  with  a  frost  the  evening  succeeding ;  which  per- 
haps may  be  accounted  for  in  the  following  manner  :  A 
few  days  preceding  the  frost  had  been  very  warm,  which 
occasioned  a  wind  to  set  in  from  a  southerly  direction, 
which  brought  with  it  a  great  quantity  of  aqueous  vapor, 
which  it  was  probable  was  raised  into  the  atmosphere  in 
the  warm  regions  surrounding  the  Mexican  Gulf;  and  after 
being  wafted  to  the  north,  through  a  very  high  region 
of  the  atmosphere,  it  there  became  mixed  with  a  great 
quantity  of  nitrous  particles,  which  were  floating  in  the 
atmosphere  from  the  cold  regions  of  the  north.  Upon 
the  conjunction  of  the  aqueous  vapor  with  these  nitrous 
particles,  it  became  immediately  condensed,  and  descended 
in  rain.  By  these  means,  the  atmosphere  being  freed 
from  vapor,  and  a  great  quantity  of  those  nitrous  parti- 
cles being  brought  by  the  rain  nigh  to  earth,  occasioned  a 
coldness  in   the  circumambient   air,  which  produced   the 


COLLEGE    CORRESPONDENCE.  23 

frost.  This  is  the  method  in  which  I  account  for  these 
sudden  transitions  from  heat  to  cold.  If  you  have  any 
better  theory  for  explaining  such  phenomena,  I  should  be 
very  happy  if  you  would  communicate  it  to  me."  [He 
alludes  to  illness  still  among  the  students,  and  concludes 
thus:]  "I  am  now  attending  Dr.  Smith's  lectures 
upon  Materia  Medica,  which  I  find  agreeable  and  instruc- 
tive." 

He  writes  from  Rockingham  :  — 

"Feb.  2,  1802. 

..."  I  opened  my  school  on  the  succeeding  day,  and 
found  it  to  consist  of  about  eighty  or  ninety  large  igno- 
rant scholars."  .  .  . 

"April  2,  1802. 

"  Friend  Carter,  —  This  day  completes  twenty-one 
solar  revolutions  since  my  egress  into  the  world.  But 
twenty-one  years,  when  they  are  gone,  do  appear  as  short 
as  one.  However  fast  time  has  fled  heretofore  with  me, 
it  now  drags  heavily  along.  I  can  say,  as  the  divines  ex- 
press it  in  their  prayers,  'I  have  wearisome  days  and 
nights  appointed  to  me.'  " 

He  then  describes  an  attack  of  measles,  from  the 
effects  of  which  he  was  a  long  time  in  recovering. 
He  terminates  by  hoping  that  bad  health  will  not  pre- 
vent him  from  attending  Dr.  Smith's  lectures,  which 
were  about  to  commence.  He  likewise  constantly 
alludes  to  this  gentleman,  in  terms  of  respect,  as  his 
medical  attendant. 

"May  5,  1802. 

•  •  •  "  I  have  now  been  unable  to  study  any  for  about 
six  weeks  ;  but  I  can't  help  myself,  the  president  says, 
and  I  must  be  resigned,  for  Providence  never  hurts  any- 
body." 


'-24  GREEK    ORATION. 

It  would  appear  from  the  following,  that  demo- 
cracy was  not  in  the  ascendant  at  Hanover,  in  June 
30th,  1802:  — 

..."  The  anniversary  of  our  Independence  will  be 
celebrated  in  this  place  on  Monday  next,  when  an  oration 
is  expected  by  Thomas  A.  Merrill,  A.B.  preceptor  of  the 
academy  in  this  town,  —  a  true  federalist.  Great  were 
the  exertions  of  the  democrats  to  prevent  the  triumphs  of 
federalism  on  this  occasion ;  but,  with  all  their  exertion, 
they  obtained  but  fourteen  votes." 

His  last  letter  from  Dartmouth  is  dated  just  before 
the  Commencement-day  at  which  he  was  graduated, 
viz.  August,  1802.  In  it  he  urges  his  friend  Carter 
to  come  to  Hanover. 

A  very  neatly  written  Greek  manuscript  was 
found  among  his  papers  after  his  death.  I  presume 
it  was  the  Oration  delivered  at  the  time  of  his  gra- 
duation. I  do  not  suppose  that  it  is  written  in  the 
purest  Attic  idiom.  It  doubtless  shows  something 
of  its  origin  in  the  backwoods  of  New  Hampshire. 
A  translation  of  it,  in  his  own  handwriting,  has 
likewise  been  found ;  and  as  it  illustrates,  in  some 
degree,  his  views  of  nature  and  of  God,  I  have 
thought  it  worth  preservation.     (Appendix  A.) 


2d 


CHAPTER   III. 


FROM    1802    TO    1805.  JET.   21- 


Early  Tendency  to  the  Study  of  Medicine.  —  Anxieties  on  leaving 
College.  —  Dr.  Nathan  Smith,  Preceptor.  —  Sketch  of  Dr. 
Smith's  Life.  —  Preliminary  Education  necessary  to  the  Medi- 
cal Student.  —  Influence  of  Dr.  Smith  on  Mr.  Twitchell.  — 
Practical  Anatomy.  —  Obstructions  to  the  Study  of  it.  —  Dissec- 
tions in  Early  Times.  —  Sir  Astley  Cooper  on  Resurrectionizing 
in  England.  —  Dissections  in  America.  —  Difficulties  of  the 
Physician.  —  Necessary  for  him  to  brave  Public  Opinion.  —  Mr. 
Twitchell  as  a  Practical  Anatomist.  —  Dissections  should  be 
legalized  in  New  Hampshire.  —  Correspondence.  —  Lecturer  on 
Anatomy.  —  Removal  to  Norwich.  —  Mr.  Twitchell  invited  to 
deliver  a  Medical  Dissertation  at  Dartmouth  College. 

From  early  childhood,  Mr.  Twitchell's  thoughts  had 
been  led  to  the  profession  of  medicine.  During  his 
college  course,  his  intimacy  with  Dr.  Nathan  Smith 
had  tended  still  further  to  guide  him  onward  in  the 
same  path.  It  was  therefore  a  matter  of  very  little 
diihculty  for  him  to  determine,  when  leaving  college, 
which  of  the  three  professions  was  most  adapted  to 
his  nature.  He  hesitated  not  a  moment,  and  em- 
braced that  of  medicine.  But  how  cheerless  was 
the  prospect  before  him  ! 

Poor,  without  rich  friends  or  father  to  assist  him, 
the  task  of  gaining  an  honorable  fame  and  com- 


26  MEDICAL    STUDIES. 

petency  seemed  too  great.*  In  consequence  of  this 
thought,  he  was  seized  with  one  of  those  fits  of 
abstraction  and  despondency,  which  subsequently, 
for  nearly  forty  years,  at  times  almost  wrecked  his 
mind.  On  the  occasion  of  his  leaving  college,  he 
was  observed  to  be  very  sad.  Once  he  stood, 
wholly  lost  in  thought,  gazing  at  the  open  sky,  and, 
on  coming  to  himself  again,  found  that  he  had  taken 
no  note  of  time ;  for  nearly  two  hours  had  passed 
while  he  had  been  thus  occupied. 

Notwithstanding  these  occasional  attacks  of  de- 
pression, he  entered,  in  1802,  with  great  zeal,  on 
the  pursuit  of  his  profession,  under  the  care  of  Dr. 
Nathan  Smith.  I  have  already  alluded  to  the  re- 
markable character  of  this  gentleman  ;  but  the  im- 
mense influence  he  had  over  Twitchell's  mind 
makes  it  not  inappropriate,  that  a  few  words  should 
be  devoted  to  his  life.  This  is  in  fact  absolutely  ne- 
cessary, if  we  would  trace  all  the  great  influences 
that  tended  to  mould  the  mind  of  Twitchell. 

Nathan  Smith  f  was  born  Sept.  30,  1762,  at  Reho- 
both,  Mass. ;  but  his  parents  soon  migrated  to  Ches- 
ter, Vt.  He  attended  the  common  schools  in  early 
life;  and,  while  he  was  yet  in  early  youth,  the  great 
days  of  the  Revolution  of  1775  dawned  upon  this 
country.      At  the  latter  part  of  that  stormy  war  for 

*  He  certainly  possessed,  in  an  eminent  degree,  what  has  been 
quaintly  styled  "  the  wholesome  stimulus  of  prospective  -want." 

f  I  have  gleaned  all  my  knowledge  of  Dr.  Smith's  life  and 
character  from  the  interesting  eulogy,  delivered  at  the  time  of  his 
death,  by  his  friend  and  colleague,  Jonathan  Knight,  M.D.  See 
Medical  and  Surgical  Memoirs,  by  Xathan  Smith,  edited  by  his 
son  Nathan  R.  Smith.     Baltimore,  1831. 


DR.    NATHAN    SMITH.  27 

independence,  and  while  still  in  his  teens,  he  was 
drafted  into  the  Vermont  militia,  to  repel  the  incur- 
sion of  Indians  on  the  frontiers.  Encamped  in  the 
wilderness,  constantly  in  peril  from  the  rifle  and  craft 
of  the  savage,  he  gained  a  robust,  manly  form,  as 
well  as  a  strong  and  bold  mind.  Exposed  thus  early 
to  laborious  toil,  he  was,  all  unawares  to  himself, 
preparing  for  the  earnest  battle  of  life  that  was  des- 
tined for  him. 

On  his  return  from  the  wars,  he  became  teacher 
of  the  District  School  in  the  vicinity  of  his  residence. 
Whilst  thus  engaged,  one  of  those  curious  events 
occurred  to  him,  which,  the  more  we  study  biogra- 
phy, the  more  commonly  do  we  perceive  to  happen 
in  the  life  of  every  celebrated  man. 

Sir  Christopher  Wren's  greatest  fame  can  be  di- 
rectly traced  to  the  fire  which  desolated  London 
in  1666.  The  whole  energies  of  Clarkson's  soul 
were  turned  to  the  main  object  of  his  life  of  fifty 
subsequent  years,  by  his  visit  to  the  London  and 
Liverpool  slave-ships,  in  1784  and  1785.  The 
Revolution  in  our  country  has  made  the  name  of 
Washington  so  mighty,  that  it  will  be,  as  expressed 
by  Lord  Brougham  in  his  splendid  metaphor,  one  of 
the  grand  tests  of  the  progress  of  the  human  race. 
Wherever  we  look,  we  see  these  "  accidents  of 
fortune,"  as  the  skeptic  calls  them,  or  "  special  pro- 
vidences," as  the  pious  soul  loves  to  regard  them, 
always  happening  just  at  the  right  time,  to  bring 
forward  a  human  being  into  the  path  to  which  his 
nature  leads  him.  "  There  is  a  divinity  that  shapes 
our  ends,  rough  hew  them  as  we  may  ;  "  and  who 


28  DR.    NATHAN    SMITH. 

can  tell  what  impulse  first  led  Nathan  Smith  to 
attend  an  operation  upon  the  human  body,  per- 
formed by  Dr.  Goodhue,  then  the  most  eminent  sur- 
geon of  that  district,  subsequently  father-in-law  of 
young  Twitchell  ?  Smith  was  twenty-four  years  of 
age  when  this  happened  ;  and,  although  he  had  paid 
no  attention  to  medicine  or  surgery  before,  the  sight 
aroused  all  the  latent  fire  within  him.  He  asked  Dr. 
Goodhue  to  allow  him  to  commence  the  study  of  me- 
dicine in  his  office.  Most  wisely,  however,  did  that 
sagacious  man  tell  him  it  could  not  be  allowed.  His 
preliminary  education  was  lamentably  deficient.  He 
wTas  therefore  ordered  to  fit  himself  to  enter  col- 
lege, before  he  could  be  received  by  Dr.  Goodhue.* 

*  Dr.  Perry,  of  this  city,  informs  me  that  lie  heard  from  Dr. 
Goodhue  the  folio-wing  account  :  Young  Smith  was  a  teacher  of 
the  adjacent  District  School ;  and  it  was  rumored,  that  the  impor- 
tant operation  of  amputation  of  the  thigh  was  to  be  performed 
by  Dr.  Goodhue.  The  village  -was  alive  upon  the  subject,  and 
many  gathered  at  the  house  of  the  patient,  apparently  attracted 
by  simple  curiosity.  "When  all  was  prepared,  Dr.  Goodhue, 
not  having  sufficient  medical  assistance,  asked  of  the  assembled 
company,  whether  any  one  would  hold  the  limb  that  was  to  be 
taken  off.  Immediately,  a  strange  and  rather  ungainly  back- 
woodsman-looking youth  stepped  up  boldly,  and  offered  his  aid. 
Dr.  Goodhue  was  struck  with  the  apparently  intense  interest  that 
he  took  in  the  proceedings,  and  with  his  unflinching  steadiness 
of  nerve.  Smith  even  tied  the  arteries  as  Goodhue  took  them  up, 
and  did  so  without  tremor.  After  all  was  finished,  and  most  of 
the  villagers  had  left,  the  youth  still  remained  fixed  on  the  spot, 
with  his  hands  in  his  pockets,  apparently  in  deep  thought.  Sud- 
denly, he  exclaimed  in  Yankee  phrase  and  tone,  somewhat  as  fol- 
lows :  —  "  Look  ye  here  !  I  think  I  should  like  to  study  medicine 
with  you.  I  am  the  teacher  in  your  District  School ;  and,  after 
my  term  has  finished,  I'll  begin."  Dr.  Goodhue  scanned  him 
well,  and  answered,  "  Stop,  young  man —  not  so  fast.    Let  me  see 


DR.    NATHAN    SMITH.  29 

Nothing  daunted,  however,  Smith  placed  himself 
under  the  care  of  the  Rev.  Mr.  Whiting,  of  Rock- 
ingham, for  three  years  ;  and  three  years  more  he 
studied  medicine  under  Dr.  Goodhue.  How  does 
such  counsel  as  this  eminent  physician  gave  the 
young  man  put  to  shame  the  modern  doctrines  of 
rapid  courses  of  instruction,  and  quick  grinding  out 
of  medical  students ! 

Commencing  practice,  Dr.  Smith  still  felt  his  im- 
perfect knowledge  of  his  profession.  He  therefore 
resigned  practice,  and  came  down  to  Old  Harvard, 
to  sit  at  the  feet  of  the  elder  Warren  and  of  Water- 
house,  under  whose  instructions  he  was  graduated 
with  distinguished  honors.  Returning  to  his  own 
State,  he  projected  alone  the  formation  of  the  Medi- 
cal School  at  Dartmouth.  Aided  by  his  friend,  Dr. 
Lyman  Spaulding,  as  Lecturer  on  Chemistry,  he 
commenced  a  course  of  lectures  on  medicine  and 
surgery;  thus  embracing,  in  one  grasp,  the  do- 
mains of  medicine  in  its   widest  sense,  and  which 

what  you  know."  Finding,  as  stated  in  the  text,  that  he  was 
deficient  in  his  preliminary  education,  Dr.  Goodhue  stated  his 
opinion,  and  the  youth  left.  Dr.  Goodhue  never  thought  of 
the  subject  afterwards,  until,  many  months  subsequently,  an  un- 
known individual  appeared  suddenly  at  his  house,  with  his  pack 
on  his  back,  apparently  prepared  to  stay.  "  Well,"  cried  the 
stranger,  "  I  have  come  back  to  study  with  you ;  but  you  must 
let  me  earn  my  board,  for  I  have  spent  all  my  money  in  fitting,  as 
you  told  me,  for  college."  An  explanation  immediately  took 
place ;  and  Dr.  Goodhue,  perceiving  the  qualities  possessed  by 
his  extraordinary  companion,  generously  offered  him  a  home  and 
medical  tuition,  while  the  youth  on  his  part  was  to  assist,  by 
performing  any  manual  labor  that  might  arise  in  the  country- 
physician's  family. 
3* 


30  DR.    NATHAN    SMITH. 

now  occupies  the  attention  of  at  least  seven  profes- 
sors in  every  well-regulated  school.  Dissatisfied, 
however,  with  any  thing  short  of  being  as  perfect 
in  his  art  as  possible,  he  again  resigned  practice, 
made  a  voyage  to  Europe,  and  spent  one  year  in 
Great  Britain,  most  of  the  time  under  the  guidance 
of  the  professors  of  the  then  far-famed  Edinburgh 
school. 

His  return  was  a  signal  for  unexampled  success. 
As  a  surgeon  and  a  professor  of  surgery,  he  stood 
preeminent.  His  active,  inquisitive  mind,  his  extra- 
ordinary memory,  his  practical  skill  in  the  details 
of  life,  his  moral  courage,  his  unbounded  kindness  of 
heart,  his  purity  of  thought  and  deed,  —  all  combined 
to  lead  him  on  to  fame.  From  1798  to  1813,  his 
career  was  unbroken  at  and  about  Hanover.  He 
then  removed  to  the  wider  sphere  of  the  Professor- 
ship of  Surgery  at  New  Haven  ;  and,  finally,  full  of 
honor,  surrounded  by  those  who  loved  him,  and 
mourned  by  all,  he  sunk  in  peace  in  the  sixty-seventh 
year  of  his  age. 

Undoubtedly,  such  a  man  was  one  to  stir  the  blood 
of  a  youth  like  Twitchell ;  and  equally  certain  is  it, 
that  Dr.  Smith  must  have  appreciated  all  the  good 
qualities  of  his  young  friend.  It  is  because  I  think 
that  Dr.  Smith  had  more  effect  than  any  other  man 
or  set  of  men  in  bringing  the  pupil  up  to  what  he 
subsequently  became,  that  I  have  felt  it  right  to  dwell 
so  long  upon  the  character  of  the  master. 

A  former  friend  and  pupil  of  Smith,  and  a  fellow- 
student  with  Twitchell,  speaks  thus  :  "  Dr.  Smith 
was  remarkable  for  his  profound  views  and  for  his 


PRACTICAL    ANATOMY.  31 

great  disinterestedness.  He  would  do  any  thing,  and 
perform  any  labor,  for  the  sake  of  humanity  and  for 
science.  *Hence  Twitcheli  was  attracted  towards 
him." 

We  can  readily  believe,  that,  with  circumstances 
so  nearly  allied,  and  with  characters  so  marked,  and 
yet  so  similar,  these  two  men  Avould  have  been 
united.  In  Twitcheli,  Dr.  Smith  had  just  what  he 
wanted  as  a  youthful  assistant  ;  and  in  Smith, 
Twitcheli  found  not  merely  a  high-toned  preceptor, 
permeated  with  a  mild  and  free  philosophy,  but 
one  of  the  most  kind  and  self-sacrificing  of  friends. 
Persons  now  living  remember  well  the  entire  union 
of  the  two ;  and  the  pupil  seems  to  have  ever  acted 
towards  his  preceptor  in  accordance  with  the  noble 
Hippocratic  rule,  of  entire  devotion  of  himself,  not 
merely  to  his  master  in  physic,  but  likewise  to  that 
master's  family.* 

Twitcheli  was  very  much  occupied,  during  his 
pupilage,  with  the  thorough  study  of  anatomy.  Al- 
most all  the  time,  he  was  at  the  dissecting  room. 
This  fact  leads  to  a  subject,  which,  though  it  may 
be  unpleasant  to  many,  needs  some  notice.  I  allude 
to  the  connection  of  these  two  men  in  the  study  of 
practical  anatomy.  As  an  introduction,  allow  me  to 
allude  to  some  of  the  difficulties  that  have  attended 
this  study. 

*  "  I  will  honor  as  my  parents  the  master  who  has  taught  me 
this  art  (medicine),  and  endeavor  to  minister  to  all  his  necessities. 
I  will  consider  his  children  as  my  own  brothers,  and  will  teach  them 
my  profession,  should  they  express  a  desire  to  follow  it,  without 
remuneration  or  written  bond."  —  Oath  of  Hippocrates. 


32  ITS    IMPORTANCE. 

Strange  as  it  may  seem,  although  a  thorough 
knowledge  of  the  human  frame  is  absolutely  essen- 
tial to  perfection  in  the  medical  profession,  and 
dissections  are  the  only  groundwork  of  all  true 
knowledge  in  our  art,  the  study  of  practical  ana- 
tomy has  been,  until  recently,  prohibited  either  by 
public  opinion  or  by  statute  law.  Consequently, 
dissections  were  much  neglected  in  former  ages. 
Some  physicians  hoped  to  learn  man's  organization 
by  examining  the  bodies  of  lower  animals,  —  a  very 
absurd  and  inaccurate  mode  of  studying  human  ana- 
tomy !  But  the  really  great  men  of  the  profession, 
feeling  dissatisfied  with  this  very  superficial  know- 
ledge, have  always  braved  public  opinion,  or,  in 
a  secret  way,  have  avoided  its  censure.  Dissections 
have  been  made  by  some  few  in  every  age.* 

In  England,  till  within  the  present  generation, 
a  man  convicted  of  dissecting  a  human  body  was 
liable  to  be  classed  with  felons;  and  the  highest 
penalties  were  inflicted  on  any  one  who  procured  a 
corpse  for  that  purpose.  In  consequence  of  these 
enactments,  a  class  of  desperate  men  arose  in  Eng- 
land, who  for  years  carried  on  a  trade  in  dead  bodies 
with  the  chief  surgeons  and  teachers  of  anatomy 
in  Great  Britain.  So  daring  and  successful  were 
they,  that  Sir  Astley  Cooper,  in  a  reply  to  a  com- 
mittee of  the  House  of  Commons,  said  :  "  The  law 
does  not   prevent  our   obtaining   the   body  of  any 

*  The  eminent  anatomist,  Vesalius,  three  hundred  years  ago, 
was  cited  to  appear  before  the  Inquisition,  on  the  ground  of  im- 
piety in  dissecting  the  human  body  ;  and  it  is  said,  that  the  power 
of  the  Spanish  king  alone  saved  him  from  destruction. 


ITS    DIFFICULTIES.  33 

individual,  if  we  think  proper;  for  there  is  no  person, 
let  his  situation  in  life  be  what  it  may,  whom,  if  I 
were  disposed  to  dissect,  I  could  not  obtain."  *  Such 
was  the  state  of  things  up  to  1832,  when  the  British 
Parliament  took  up  the  subject  like  reasonable 
men,  and  passed  a  bill  legalizing  the  study  of  ana- 
tomy, and  making  provision  for  dissections.  Under 
this  law,  some  of  the  most  serious  evils  have  sub- 
sided, f 

We  now  turn  to  our  country,  where  the  same 
opinions  and  laws  against  dissections  have  likewise 
existed,  until  within  a  very  short  period,  in  all  the 
States.  And  where  is  the  physician  of  twenty  years' 
standing  in  his  profession,  who  does  not  remember  the 

*  Life  of  Sir  Astley  Cooper,  by  Bransby  Cooper,  1843,  vol.  i. 
407. 

f  Hansard  (Parliamentary  Debates,  1830 — 33)  gives  very  in- 
teresting reports  of  the  discussions  which  took  place  before  a  law 
could  be  passed.  The  Duke  of  Sussex,  Sir  Robert  Peel,  Sir  Robert 
Inglis,  Messrs.  Warburton,  Macaulay,  Hume,  and  O'Connell,  bore 
their  parts  on  the  affirmative  side  of  the  question.  Mr.  Hunt,  the 
representative  of  the  ultra-opponents,  proposed  that  no  one  should 
ever  be  allowed  to  dissect,  unless  he  would  sign  a  paper  that  he 
was  willing  his  own  body  should  be  used  for  dissection.  Mr. 
Macaulay,  as  an  illustration  of  the  importance  to  all,  to  the  rich 
as  well  as  the  poor,  that  physicians  should  be  experts  in  ana- 
tomy, cites  the  case  of  Leopold,  Duke  of  Austria,  the  conqueror 
of  Richard  the  Lion-hearted.  This  great  commander  was  thrown 
from  his  horse,  and  fractured  his  leg.  The  physicians  said  that  the 
limb  should  be  amputated ;  but  none  possessed  sufficient  skill  to 
undertake  the  task.  In  despair  and  agony,  the  duke  seized  a 
hatchet,  placed  it  on  his  mangled  limb,  and  ordered  an  attendan  t 
to  lop  off  the  useless  member.  It  was  done  ;  and  the  duke  died 
of  the  hemorrhage  from  the  spouting  artery  !  If  anatomy  were 
not  now  studied,  would  not  such  cases  be  of  constant  occurrence  ? 


34  PRACTICAL    ANATOMY. 

revolting  scenes  in  which  but  too  many  of  us  were 
forced  to  engage,  however  abhorrent  the  occupation 
might  have  been  to  our  own  feelings  ?  We  found 
ourselves  engaged  in  the  study  of  an  honorable  art, 
whose  object  is  the  relief  of  suffering  humanity. 
Practical  dissections  were  absolutely  essential  to  a 
knowledge  of  this  art.  No  one  could  ever  hope  to 
gain  a  thorough  insight  into  medicine,  no  one  could 
ever  dare  perform  any  operation  upon  the  living 
body,  unless  he  had  studied  the  intricate  and  curious 
workmanship  of  the  human  frame.  It  was  neces- 
sary for  him  practically  to  lay  out  before  his  own  eye 
every  principal  artery,  nerve,  and  vein  ;  otherwise 
he  could  not  operate  with  safety  upon  the  quivering 
fibres  of  a  living  brother-mortal !  But  how  was  he 
to  obtain  the  means  of  pursuing  this  study  ?  He 
looked  at  the  law,  and  it  said,  A  man  who  is  found 
with  a  human  body  in  his  possession,  for  the  purpose 
of  dissection,  shall  be  considered  guilty  of  felony.* 
Public  opinion  gave  him  no  milder  answer.  Every 
time  he  entered  the  dissecting  room,  he  felt  that  he 

*  By  a  law  of  Massachusetts,  passed  March  2,  1815,  any  one 
-who  "  dug  up"  or  who  "received  "  any  human  body  for  dissect- 
ing purposes  was  liable  "  to  be  imprisoned  not  more  than  one 
vear,"  or  "  to  be  fined  not  more  than  a  thousand  dollars."  This 
law  (while  at  the  same  time  no  legal  provision  was  made  for  dis- 
sections) remained  in  full  force  until  1831,  when  the  Legislature 
of  Massachusetts  swept  the  absurd  and  impracticable  document 
from  their  statute-book,  and  thereby,  I  believe,  became  the  first 
Legislature  of  the  Anglo-Saxon  family  that  arose  above  prejudice 
upon  this  point,  and  looked  at  the  necessities  of  the  medical  pro- 
fession face  to  face.  Even  the  English  law  came  after  ours ;  and, 
as  I  am  informed,  English  statesmen  were  not  unwilling  to  seek 
wisdom  from  our  younger  commonwealth. 


ITS  INFLUENCES  ON  THE  STUDENT.        3-J 

shut  himself  out  from  much  of  human  sympathy. 
Nevertheless,  love  of  his  profession,  necessity,  a 
laudable  ambition  to  become  an  adept  in  his  art,  — 
all  summoned  him  to  break,  if  necessary,  the  absurd 
law,  and  violate  public  opinion.  It  was  a  dreadful 
alternative,  but  what  every  educated  physician,  until 
within  the  period  above  alluded  to,  has  been  sum- 
moned to  decide.  And,  without  a  single  exception, 
every  one,  either  by  his  own  act,  or  by  that  of 
another,  perhaps  a  fellow-student,  has  chosen  to  set 
at  nought  the  law. 

But  how  much  torture  of  mind  —  how  much  real 
injury  to  the  fine  texture  of  the  human  soul,  has 
been  often  produced  by  this  alternative,  many  can 
tell. 

Upon  this  subject,  I  feel  that  I  can  speak  with  the 
authority  of  one  who  has  known  what  it  was,  in  for- 
mer days,  to  dissect  a  human  body.  How  vividly, 
after  a  lapse  of  twenty  years,  come  up  now  before 
me  visions  of  hours  spent  in  the  dissecting  room ! 
Some  of  them  were  among  the  most  delightful  and 
ennobling  of  my  life ;  for  I  then  learned  to  look 
upwards  in  reverential  awe,  from  the  mystic  harp  of 
the  human  body,  to  that  higher  Power  which  had 
fashioned  all  its  varied  beauty.  Other  hours,  how- 
ever, were  of  a  far  different  character,  —  not  inherent 
in  the  nature  of  the  employment,  but  forced  upon 
me  by  the  ignorant  prejudices  of  a  so-called  enlight- 
ened community.  Deeds  were  to  be  done,  either  by 
myself,  or  by  some  one  else,  with  my  knowledge 
and  fall  consent,  but  abhorrent  to  my  inmost  nature. 
The  stern  figure  of  an  absolute  fate  seemed  to  rise, 


36  PRACTICAL    ANATOMY. 

and  tell  me  that  it  was  useless  to  resist;  for  it  was 
the  irrevocable  decree  of  society,  that  dissections 
should  be  obtained  by  those  very  deeds.  Let  not 
any  one  think  that  any  trivial  idea  merely  of  a  neces- 
sity in  the  ca^e  would  ever  have  induced  any  one 
to  undertake  the  horrible  task.  In  my  early  days 
of  professional  life,  it  was,  as  I  have  stated,  the  ab- 
solute and  fixed  fate  of  every  medical  student  to  do 
this,  or  be  recreant  to  humanity  and  his  profession. 
We  in  Boston  were  grateful  to  find  one  avaricious 
miscreant  to  take  upon  himself  the  most  onerous 
part  of  the  work  ;  but  how  country  students  were 
obliged  to  do,  may  be  learned  from  a  letter  which  I 
shall  hereafter  lay  before  the  reader.  With  them, 
every  one  had  to  bear  his  share  of  danger;  and, 
considering  the  amount  of  that  danger,  I  wonder 
that  such  a  race  of  men,  eminent  in  surgery,  ever 
arose  amongst  us.  While  I  wonder,  I  glory  in  the 
fact,  that,  notwithstanding  all  the  fierce  attempts  of 
society  to  dwarf  the  medical  profession  in  this,  its 
primary  elements  of  growth,  there  has  always  been 
an  elastic  force  within  our  body,  capable  of  hurling 
off  the  pressure  which  a  narrow  legislation  has  con- 
stantly attempted  to  exert  upon  it.  All  honor,  then, 
to  those  bold  men  who  were  willing,  like  Smith  and 
Twitchell,  to  risk  fame  for  the  sake  of  a  thorough 
knowledge  of  the  profession  !  For  one,  I  give  my 
most  grateful  thanks  to  all  those  fathers  of  the 
profession,  who,  directly  or  indirectly,  have  listened 
to  "  a  higher  law  than  human  statute,"  whilst  that 
was  base  and  grovelling,  and  have  dissected  in  the 
face  of  human  law ;  and  who  likewise,  by  unremit- 


PERILOUS    ADVENTURES.  37 

ting  efforts  in  Massachusetts,  have  at  length  brought 
us  to  the  point  that  human  dissection  can  be  per- 
formed openly  and  with  the  sanction  of  the  State. 

An  undaunted  courage,  great  sagacity  and  self- 
possession,  inflexible  perseverance,  and  an  iron  frame, 
were  needed  on  the  part  of  any  one  to  enable  him 
to  be  repeatedly  successful  on  such  occasions  as  I 
have  hinted  at.  Mr.  Twitchell,  as  the  assistant 
of  Dr.  Smith,  then  sole  Professor  of  the  Medical 
School  at  Dartmouth,  had  these  characteristics. 
This  gentleman,  like  other  teachers,  needed  demon- 
strations in  practical  anatomy  for  the  instruction  of 
his  class.  They  were  as  necessary  for  the  life  of  his 
school,  as  the  air  we  breathe  is  essential  to  ourselves. 
It  has  been  reported  to  me,  that  Dr.  Smith  depended 
almost  wholly,  if  not  entirely,  upon  his  young  and 
ardent  friend  for  the  procurement  of  subjects  for 
dissection.  Mr.  Twitchell  always  wrent  alone  when 
engaged  in  these  excursions,  because  he  could  not 
trust  any  one's  courage  but  his  own.  For  many 
years  he  labored  thus  a  great  deal  for  Dr.  Smith. 
He  was  himself  constantly  dissecting,  and  therebv 
preparing  for  his  future  course  of  honorable  repu- 
tation as  a  surgeon.  He  was  often  in  infinite  peril. 
On  one  occasion  he  was  arrested  ;  but,  by  some  easy 
ruling   of  the   law,    he   escaped.  *      Tradition    has 

*  Another  serious  evil  of  these  laws  was  the  tendency  to  wink 
at  their  violation,  which  was  exhibited  by  the  very  magistrates 
themselves.  These  gentlemen,  in  advance,  as  they  were,  of  pub- 
lic opinion,  required  strong  proof  of  a  fact  before  they  would 
commit  a  man.  A  most  striking  example  of  this  I  met  with 
during  my  own  pupilage.  A  fellow-student  had  been,  to  my 
certain  knowledge,  engaged  in  raising  a  body  in  the  vicinity 
4 


38  PRACTICAL    ANATOMY. 

handed  down  very  many  singular  adventure?,  which 
he  met  with  on  these  various  occasions.  They  il- 
lustrate his  peculiar  traits  of  character,  —  his  bold 
and  fearless  temper,  his  indefatigable  perseverance, 
his  shrewdness  in  meeting  all  the  diversities  of  human 
nature,  and  even  his  love  of  drollery.  I  might  tell 
of  his  long  rides,  sometimes  over  a  hundred  miles 
in  extent,  by  night  and  by  day,  in  sunshine  and 
storm,  of  his  various  accidents  and  hair-breadth 
escapes;  but  it  would  be  unwise  to  do  more  than 
simply  allude  to  this  phase  in  his  life.  And,  in  doing 
so,  I  do  not  put  him  forward,  it  will  be  perceived,  as 
an  exception  to  the  general  rule.  All  engaged  in  the 
same  pursuits,  either  per  se  or  per  alios.  Twitchell, 
however,  was  unique  in  these  transactions,  as  in  every 
thing  else;  unbounded  in  his  energy,  with  a  mind 
ever  fertile  in  resources,  and  a  courage  that  never 
faltered. 

Some  may  doubt  the  expediency  of  even  referring 
to  this  question  ;  but  truthful  dealing  with  the  pupil- 
age and  earlier  professional  life  of  Dr.  Twitchell  re- 
quires me  to  do  so,  even  if  I  had  no  other  reasons 

of  where  I  now  write.  I  knew  it,  and  the  students  had  consulted 
about  it;  but,  11  o'clock  at  night,  news  came  to  us  that  he  had 
been  arrested.  His  fate  seemed  certain,  and  yet  he  proved  an 
alibi.  I  have  thought  little  of  "  alibis"  ever  since.  I  trust,  how- 
ever, that  no  one  will  suppose  that  I  believe  any  person  wilfully 
perjured  himself,  or  that  the  judge  did  wrong.  In  a  question  of 
time,  so  small  as  five  or  ten  minutes,  an  individual  might  be  mis- 
taken ;  and,  as  the  defendant  obtained  evidence  of  his  whereabouts 
during  the  evening  from  others  than  those  who  knew  his  exact 
plans,  a  confusion  of  evidence  was  produced,  which,  I  think, 
would  have  piizzled  any  lawyer,  however  astute  he  might  have 
been. 


PRACTICAL    ANATOMY    IN    NEW    HAMPSHIRE.  39 

which  I  deem  amply  sufficient.  Some  of  these  rea- 
sons I  will  but  very  briefly  mention  in  concluding 
the  subject. 

The  surreptitious  obtaining  of  bodies  for  dissections 
is  not  carried  on  now  in  New  Hampshire  or  New 
England.  There  is  not  the  same  necessity  that 
existed  at  the  times  I  speak  of.  Neither  the  public 
nor  the  profession  would  at  present  allow  of  any 
such  proceedings.  But  we  give  no  thanks  to  the 
statesmanship  of  New  Hampshire  for  the  great  re- 
lief, thus  afforded  to  the  profession  in  the  Granite 
State.  In  fact,  were  it  not  that  other  States  are 
more  liberal  in  their  provisions,  and  other  means  for 
the  procuring  of  bodies  are  partially  at  least  laid 
open  to  the  profession,  New  Hampshire  would  still 
be  doomed  to  suffer  from  the  same  practices  as 
were  needed  in  former  days.  Such  a  state  of  things 
is  unworthy  of  a  free  and  enlightened  commonwealth. 

Every  opportunity  should  be  afforded  for  the  study 
of  anatomy  by  the  medical  profession,  in  the  same 
way  as  common  grammar-school  education  is,  by 
positive  enactments,  thrown  open  to  the  whole  people. 
The  inconsistency  of  any  other  course  becomes  espe- 
cially manifest,  when  it  is  remembered  that  the  sta- 
tute-book inflicts  a  severe  penalty  on  any  surgeon 
or  physician  who  is  guilty  of  malpractice.  It  pun- 
ishes a  man  for  not  doing  well  wThat  it  virtually  re- 
fuses to  aid  him  in  learning.  Nay,  farther,  so  far  as 
any  legislation  now  exists  upon  the  subject,  New 
Hampshire  really  endeavors  to  restrain  the  medical 
student  from  the  thorough  study  of  the  profession.* 

*  In  1834  a  law  was  passed,  legalizing  the  study  of  anatomy. 


40  OBJECTIONS    TO    ANATOMICAL    STUDIES. 

But  why  has  there  always  been  this  antagonism 
between  the  medical  profession  and  the  public  ?    Let 
us  look  fairly  at  the  question.     The  right  and  pro- 
priety, nay,  the  duty,  of  giving  burial  to  the  dead, 
seems  to  have  ever  been  one  of  the  strongest  senti- 
ments in  man.     The  pathetic   appeal  of  Abraham 
for  the  burial-place  in  the  field  of  Machpelah,  where 
he  might  inter  the  body  of  Sarah  his  wife,  moves  us 
as  if  it  were  a  tale  of  yesterday.     The  equally  beau- 
ful  death-bed  request  of  Jacob,  that   he  might  be 
carried  back,  and  buried  with  Abraham  and  Sa- 
rah,  by  the  side  of  Leah,   is  still  read  as  a  most 
touching  natural  appeal  of  a  dying  old  man  to  a 
pious  son.     Of  the  mighty  anathemas  of  Jeremiah 
against  the   Jews  of  later  days,  none  strike  us  as 
more  appalling  than  that  in  which  he  proclaims  that 
the  fathers  and  mothers,  sons  and  daughters,  shall 
"die  grievous  deaths,  and  shall  not  be  lamented, 
neither  shall  they  be  buried,"  but  shall  be  as  ofTal 
on  the  face  of  the  earth.     By  the  Greeks,  it  wras 
considered   impious   for  any  one    to  allow   even  a 
stranger    to   remain   uninterred  ;    for,   according  to 
their   mythology,   the   souls   of    these    unfortunates 
were  obliged  to  wander  for  a  hundred  years,  before 
they  could  enter  the  mansions  of  the  blessed.     The 
Romans  held  similar  views  in  regard  to  the  impor- 
tance of  properly  caring  for  the  dead,  though  with 
some  variation  in  their  rites.    And,  finally,  as  we  turn 
to   Christendom,   and  read  the  grand   and   solemn 

In  1842  that  was  repealed,  when,  the  Revised  Statutes  were  passed  ! 
The  reason  for  this  omission  was,  as  I  hear,  that  the  common  law 
allows  of  dissections  ! 


REVERENCE  TO  THE  DEAD.  41 

burial  service  which  has  been  used  for  centuries  in 
the  Catholic  and  English  churches,  or  view  the  more 
simple  formulas  of  the  various  sects  of  Christians, 
we  feel  convinced  that  the  office  of  paying  a  last 
service  to  those  who  have  left  this  life  has  been 
hallowed  by  time,  and  is  in  accordance  with  some 
of  the  purest  instincts  of  the  human  heart.  If,  then, 
these  rites  are  so  sacred  in  the  eyes  of  all,  it  is 
natural  that  we  should  resist  any  proposition  which 
threatens  to  desecrate  them.  The  idea  of  dissection 
must  at  first  suggest  this  mournful  thought. 

There  is  another  and  a  still  more  influential 
cause,  which  makes  us  shrink  from  the  dissection  of 
a  corpse.  With  the  conception  of  death  comes  up, 
by  the  closest  train  of  associations,  the  awful  idea 
of  that  mysterious  power  which  has  laid  low  and 
cold  the  living  man.  Not  only  do  the  dead  seem 
mutely  to  appeal  to  us  to  perform  for  them  the 
last  and  only  act  of  affectionate  respect  which  re- 
mains, before  their  final  return  to  their  native  dust ; 
but  God  himself,  working  in  our  own  hearts,  likewise 
urges  us.  It  therefore  becomes  almost  impious  to 
approach  the  dead  with  even  seeming  irreverence. 
To  the  superficial  observer,  the  thought  of  dissection 
carries  with  it  this  idea  of  sacrilege.  How  dare  we 
touch  with  our  profane  hands  that  which  has  been  so 
recently  a  living  temple  of  the  eternal  God  ! 

With  these  two  objections,  I  presume,  every  high- 
minded  physician  will  fully  sympathize.  But,  at  the 
same  time,  every  man  in  our  profession  will  feel  that 
there  are  duties  to  the  living1  that  are  more  sacred 
than  those  which  we  owe  to  the  dead.     To  relieve 

4* 


42  SURGERY    DEPENDENT    OX    ANATOMY. 

the  sufferings  of  humanity  is  our  object.  I  would 
hope,  that  at  times  it  is  among  our  holiest  privileges 
to  be  the  vicegerents  of  Heaven  in  the  saving  of  hu- 
man life.  In  order  to  fulfil  this  mission  in  strict 
accordance  with  the  nobleness  of  its  aim,  we  must 
dissect  the  dead.  Where  is  there  a  community  in 
which  human  life  has  not  been  preserved  by  modern 
surgery  ?  And  how  has  modern  surgery  arisen  ? 
Solely  by  dissections  of  the  dead.  If  we  turn  to 
the  domains  of  pure  medicine,  we  shall  find  the 
same  ultimate  answer.  Pathological  anatomy  is  an 
essential  element  in  every  thorough  medical  educa- 
tion. How  shall  we  learn  of  disease,  save  by  laying 
open  before  our  eyes  the  ravages  of  that  disease,  per- 
chance, upon  the  body  of  a  friend  ?  If,  then,  dis- 
sections are  necessary  for  the  well-being  of  the  living, 
shall  we  neglect  them,  merely  because  we  fear  that 
the  veil  of  sanctity,  which  shrouds  the  form  of  a  be- 
loved one,  may  be  rudely  torn  asunder,  or  that  the 
burial  rite  may  be  neglected  ?  I  think  not ;  first, 
because  dissections  are  consistent  with  a  due  respect 
for  the  human  body  ;  and,  second,  because  they  may 
not  interfere  with  the  burial  rite. 

I  do  not  believe  that,  by  the  act  of  dissection,  any 
man  ever  was  necessarily  taught  to  disrespect  a 
corpse.  I  am  well  aware  that  this  view  of  the  sub- 
ject is  contrary  to  the  commonly  received  opinions 
of  the  day.  I  allow,  moreover,  that,  to  those  unac- 
quainted with  this  process,  the  medical  profession 
may  seem  to  be  little  influenced  by  that  awe  which 
naturally  arises  in  the  unsophisticated  mind,  while 
in  the  august  presence  of  the  dead.    We  physicians 


PHYSICIANS  RESPECT  THE  DEAD.         43 

are  able,  it  is  true,  to  draw  nigh,  and  touch  without 
fear  the  no  longer  living  body.  The  intimate  study 
of  anatomy  becomes  deeply  absorbing  to  us.  But  I 
deny,  that  by  dissecting  we  necessarily  show  more 
disrespect  to  the  noblest  of  God's  works,  than  the 
clergyman  does  to  the  Bible  by  his  daily  opening  of 
the  sacred  pages. 

The  volume  of  natural  religion  is  never  so  widely 
opened,  as  when,  with  the  microscope  or  the  scalpel, 
we  trace  evidences  of  beneficent  design  in  our  or- 
ganization. I  have  never  been  able  so  surely  to 
touch  a  child's  soul  with  the  highest  idea  of  re- 
verence, as  when  in  simple  terms  I  have  shown  to 
him  the  wonderful  and  various  peculiarities  of  his 
own  frame.  But  it  may  be  said,  that,  however  much 
the  natural  tendencies  of  dissections  may  not  be 
inconsistent  with  true  reverence  and  respect,  the  real 
fact  is  that  physicians,  as  a  class,  do  not  honor  the 
bodies  of  the  dead  as  others  do.  Upon  this  point  I 
join  issue ;  and  I  declare,  that,  so  far  as  I  have  seen, 
no  class  of  men  have  more  desire  to  treat  with  due 
regard  the  relics  of  brother-mortals  than  our  pro- 
fession has.  I  cannot  now  bring  to  my  mind  more 
than  two,  or  at  the  utmost  three  physicians,  to  whom 
I  Avould  not  be  willing  to  give  up  for  dissection  my 
own  dead  body  or  that  of  a  friend,  with  the  full 
conviction  that  they  would  treat  those  remains  with 
deference.  And  shall  this  essential  means  of  instruc- 
tion be  refused,  or  granted  with  great  unwillingness, 
to  our  profession,  because  a  few  in  it  may  be  un- 
worthy of  confidence  ?     This  surely  is  not  justice. 

But  it  may  be  urged  by  some,  that,  supposing 


44  JUSTICE    TO    PHYSICIANS. 

every  respect  is  paid  to  the  body,  the  burial  rites 
will  be  neglected.  By  the  laws  of  Massachusetts, 
that  is  provided  for ;  and  so  they  might  be  in  any 
State.  In  alluding,  in  this  manner,  as  I  have  done 
before,  to  Massachusetts,  I  do  not  mean  to  indicate 
that  the  profession  has  no  further  rights  to  claim 
of  this  commonwealth.  Far  from  it.  We  are  yet 
in  darkness  upon  the  subject.  Glimmerings  only  of 
light  are  seen.  For  these  we  desire  to  be  duly 
thankful.  The  subject  deserves  a  thorough  investi- 
gation; and  the  medical  profession,  as  a  whole,  will 
never  rise  in  this  country  to  the  rank  it  ought  to 
hold,  until  better  views  are  entertained  by  the  public 
upon  this  all-important  matter.  That  investigation 
should  be  made  in  another  place.  I  should  not  have 
alluded  to  it  in  this  work,  if  it  had  not  been  somewhat 
forced  upon  me  by  the  history  I  am  endeavoring  to 
portray.  And  feeling  sure  that  these  views,  which 
have  now  been  given,  would  be  wholly  accepted  by 
Dr.  Twitchell,  I  trust  to  be  excused,  if,  in  pursuing 
them,  I  have  seemed  too  prolix.  I  confess,  more- 
over, that  during  these  remarks  I  have  had  in  view 
the  future  well-being  of  my  profession.  I  have 
wished  to  demonstrate,  at  least  in  some  slight  de- 
gree, that  the  interests  of  the  public  and  of  the 
medical  profession  are  identical,  and  that  exactly  in 
accordance  with  the  wise  liberality  of  the  public 
toward  medical  schools  will  be  the  class  of  physicians 
who  shall  hereafter  practise  medicine  and  surgery  in 
America. 

Twitchell  remained  two  years  under  the   imme- 
diate   care  of   Dr.   Smith.       They    frequently    rode 


MEDICAL    STUDENT    LIFE.  45 

together  to  attend  to  the  medical  and  surgical  prac- 
tice of  the  latter,  which,  at  that  time,  was  very 
extensive.  Twitchell  likewise  assisted  him  in  the 
chemical  department  of  the  school.  But  it  is  not 
probable  that  the  preceptor's  influence  was  confined 
to  the  mere  professional  training  of  Twitchell.  Dr. 
Smith's  high-toned  morality,  his  bold,  free  thought, 
his  spotless  purity  of  life,  all  must  have  borne  with 
power  on  the  opening  mind  of  his  pupil. 

The  following  letters  were  written  during  his 
pupilage.  They  serve  as  an  index  to  Mr.  Twitchell's 
state  of  mind.  I  have  selected  them  from  a  few, 
now  in  the  hands  of  Dr.  Carter's  daughter  :  — 

"Nov.  8,  1803. 
"  Friend  Carter,  —  In  vain  do  I  search  the  post-office 
for  your  promised  favors.  I  find  I  must  first  start  my 
quill,  with  an  anticipation  of  then  realizing  the  friendly 
effusions  of  yours.  Health  with  all  her  blushing  train 
are  my  attendants,  whilst  I,  with  insulated  attention,  con- 
centrate my  exertions  to  one  object,  that  is,  my  profession. 
Nevertheless,  I  can  employ  a  few  solitary  moments  in 
contemplating  the  fruition  of  pleasures  I  once  had  with 
now  absent  friends,  and  assign  myself  leisure  to  pour 
forth  the  effusions  of  a  grateful  heart,  in  the  acknow- 
ledgment of  their  past  favors.  But  when  I  reflect  upon  the 
many  obligations  I  am  and  shall  be  under  to  you,  and 
consider  my  incapacity  to  discharge  them,  I  then  find  that 
man  is  and  must  be  a  dependent  being,  since  he  was 
formed  for  society ;  notwithstanding  Brother  Timothy's 
arguments  to  the  contrary.  Were  it  not,  however,  for  the 
anticipation  of  a  time  when  it  will  be  in  my  power  to 
repay  obligations,  and  to  assume  more  independence  than 
I  now  can,  life  would  be  irksome.     But  I  will  have  done 


46  CORRESPONDENCE 

-with  such  uninteresting  observations,  and  attend  to  more 
current  incidents.  I  arrived  at  this  place  on  Saturday 
evening."  .  .  .  [He  alludes  to  Dr.  Smith  and  to  two  opera- 
tions he  saw  him  perform].  ..."  During  his  absence  [Dr. 
Smith's]  I  have  perused  Haller's  Physiology  and  Sharp's 
Surgery.  "Whilst  he  was  on  the  plain,  I  perused  che- 
mistry, upon  which  he  was  lecturing.  He  is  now  be- 
ginning upon  anatomy,  and  I  am  reading  Cheselden's.  I 
have  ridden  with  Smith  to  a  number  of  patients  in  the 
neighboring    towns,  and   find  his  practice  and  practical 

observations  highly  instructive 

"  Dr.  David  Carter." 

"Windsor,  Vt.,  July  1,  1804. 

"  Respected  Friend,  —  ....  With  regard  to  my  own 
situation,  it  is  very  agreeable.  I  room  with  Dr.  Smith, 
and  board  in  a  very  respectable  family  a  few  doors  off. 
The  circle  of  my  acquaintance  in  this  town  at  present  is 
not  very  large ;  but,  so  far  as  it  extends,  I  find  the  people 
very  civil  and  agreeable,  which,  I  believe,  is  the  general 
character  of  the  inhabitants.  Their  attention  to  strangers 
is  worthy  of  imitation.  My  acquaintance  with  the  ladies  is 
not  very  extensive.  I  was  introduced,  a  few  evenings  past, 
to  a  very  handsome,  polite,  and  accomplished  young  lady  ; 
but  still  she  is  the  ....  coquette  that  ever  walked  the 
earth  ;  but  no  more  of  this. 

"  I  have  ridden  with  Dr.  Smith  between  two  and  three 
hundred  miles,  and  have  seen  a  number  of  operations.  .  .  . 
I  have  hitherto  kept,  and  intend  to  keep,  a  journal  of  me- 
dical events,*  so  that  I  may  review  Dr.  Smith's  method 
of  operating  in  and  treatment  of  different  cases,  which  I 
shall  happen  to  see."  .  .  . 

*  Unfortunately,  this  journal,  if  ever  kept,  cannot  now  be 
found. 


WHILE    A    MEDICAL    STUDENT.  47 

111  subsequent  letters  he  speaks  much  more  of 
his  teacher,  and  gains  confidence  in  his  own  powers, 
as  he  says  he  shall  operate,  in  certain  cases,  dif- 
ferently from  his  great  exemplar. 

Pecuniary  difficulties  form  a  prominent  topic  in 
his  correspondence  with  Dr.  Carter  ;  and  the  infinite 
importance  of  five  or  six  dollars  to  the  poor  youth 
forms  a  striking  contrast  with  the  comfortable  exist- 
ence he  enjoyed  in  subsequent  life.  In  connection 
with  this  subject  appears,  however,  a  determination 
to  keep  clear  of  all  debts,  save  to  his  brother-in- 
law  Dr.  Carter,  to  whom  he  expresses  unbounded 
gratitude. 

Under  date  of  November  4,  1804,  I  find  the 
following  proposition  to  a  physician,  which  illustrates 
what  I  have  stated  above  in  regard  to  dissections. 
I  do  not  believe  that  such  a  plan  would  be  thought 
of  at  the  present  time.  I  give  it  as  a  sad  reminis- 
cence of  former  intolerance  and  wretched  ignorance 
on  the  part  of  the  public,  which  forced  honorable 
young  men  to  conceal  the  act  of  dissection. 

The  extract  is  as  follows  :  — 

"  In  confidence,  and  at  the  request  of  two  or  three 
of  my  fellow-students,  I  make  the  following  communi- 
cation :  I,  ,  N ,  and  perhaps  B ,  being  de- 
sirous to  make  dissections  for  a  few  weeks,  would,  if  you 

thought  proper,  and  was  willing,  come  and  reside  in 

for  that  purpose.  They  would  procure  the  subjects  at  a 
distance,  and  out  of  the  circle  of  your  practice.  I  think 
it  might  be  carried  on  in  your  study,  without  any  proba- 
bility of  detection.  They  would  board  at  the  neighbors', 
and   assign    this    spurious  reason  for  their  coming,  viz. 


48  EARLY    PRACTICE. 

that  Smith,  going  to  he  absent  from  home,  advised  them 
to  come  and  read,  and  ride  with  you  till  his  return. 
Should  you  go  to  New  York,  they  would  endeavor  to 
go  through  with  the  business  before  you  went.  If  you 
should  not,  they  would  take  time,  and  make  very  accurate 
anatomical  investigations." 

In  1805  he  commenced  practice  at  Norwich,  di- 
rectly opposite  Hanover,  on  the  other  side  of  the 
Connecticut  river.  He  settled  there  at  the  request 
of  Dr.  Smith.  I  learn,  likewise,  that  at  times  he 
lectured  on  anatomy  and  surgery,  when  the  professor 
was  ill.  His  pecuniary  success  was  not  great  at  this 
place.  He  suffered  the  pangs  which  every  young 
and  poor  physician  has  to  undergo ;  and  his  fits  of 
despondency  were  long  and  severe.  He  well  knew 
the  estimate  that  had  been  formed  of  him  ;  but  he 
saw  no  evidence  of  the  truth  of  that  estimate,  either 
in  his  own  sad  heart,  or  in  the  reception  he  met  with 
from  neighbors,  although  from  his  letters  he  ap- 
pears to  have  had  some  warm  friends.  By  others,  a 
disposition  was  evinced  to  destroy  his  reputation,  by 
the  accusation  of  having  been  engaged  in  dissec- 
tions. An  anecdote  is  told  of  his  having  said  to 
a  person  who  seemed  disposed  to  accuse  him  of  this 
as  a  very  grave  offence  to  good  morals,  "  Why, 
sir,  yes  ;  you  say  truly ;  I  have  dissected  about  a 
thousand  !  "  The  listener  was  so  astounded  by  the 
statement,  that  he  received  it  as  a  jocose  denial  of 
the  whole  matter,  and  so  ever  after  treated  it. 

The  following  extracts  from  letters  to  Dr.  Carter, 
written  during  this  period,  present  points  of  some 
interest : — 


CORRESPONDENCE.  49 


"Norwich,  Vt.,  May  11,  1805. 

"  Friend  Carter,  —  As  it  respects  myself,  you  appear  to 
doubt  my  existence  ;  but  you  may  tell  the  fair  daughters 
of  Israel  to  *  weep  not,  for  Amos  is  still  alive.'  I  have 
neglected  writing  hitherto,  hoping  that  my  prospects  would 
brighten,  and  I  should  be  able  to  give  a  better  account  of 
myself,  especially  to  a  creditor.  ...  I  hope  you  will  not  be 
discouraged  with  a  plain  narrative  of  facts.  After  I  left 
your  house,  I  rode  to  Windsor,  and  tarried  two  days  ; 
then,  with  Dr.  Smith,  I  rode  to  Hanover,  and  stayed 
there  till  Monday,  April  1,  when  I  came  to  this  town 
with  Dr.  Smith,  who  introduced  me  to  some  of  the  most 
respectable  families  in  the  place. 

"  Here  I  found  four  practitioners,  Drs.  — ,  — ,  — ,  — . 

These  two  are  as  malicious  towards  me  as  the  d .     I 

hear  but  little  from  the  others Thus,  you  see, 

I  shall  have  slow  work  in  introducing  myself  into  practice. 
My  business,  as  yet,  has  paid  but  about  two-thirds  of  my 

expenses.     I  have  had  two  cases  of  surgery Both 

did  remarkably  well.  ...  So  you  see  prospects  begin  to 
brighten  a  little.     The  other  day  I  had  the  satisfaction 

to  be  called  to  advise  with  Drs. and in  a  case 

of  epistaxis.  Their  conduct  was  a  little  ungentleman- 
like  ;  but  it  has  turned  very  much  to  my  advantage,  as  the 
spectators  very  highly  approved  of  my  conduct,  and  con- 
demned theirs.  It  would  be  tedious  to  narrate  the  whole 
transaction :  however,  if  I  could  have  a  few  more  such 
interviews,  I  should  take  courage.  I  have  a  considerable 
number  of  warm  friends,  who  appear  very  anxious  that  I 
should  tarry  among  them,  and  have  endeavored  to  intro- 
duce me  into  business,  all  that  was  in  their  power  ;  and 
some  of  the  merchants  have  gone  so  far  as  to  offer  me 
any  thing  I  may  want  out  of  their  stores,  and  take  their 


50  CORRESPONDENCE. 

pay  in   doctoring ;   and,  rather  than  I  should  leave  the 
town,  they  would  pay  for  my  board  one  year." 

The  above  shows  some  of  the  trials  of  a  young 
practitioner's  life ;  and  it  likewise  points  a  moral  to 
the  young  and  old  of  our  profession.  No  physician 
ever  gained  an  honorable  fame  by  traducing  his  neigh- 
bor. Yet  how  many  hope  to  rise  by  this  meanness  ? 
By  so  doing,  they  injure  themselves,  lower  the  stan- 
dard of  medical  ethics,  and  disgust  the  community  in 
which  they  reside. 

Under  date  of  June  4th,  1805,  he  writes  as 
follows  :  — 

"  Since  my  last,  my  business  has  rather  increased ;  but 
I  still  have  intervals,  in  which  it  is  almost  impossible 
to  restrain  the  hyps.  When  I  reflect  on  the  paucity  of 
enjoyments  and  the  exuberance  of  misery  in  this  world, 
I  think  life  is  scarcely  worth  preserving.  Yet,  again, 
ambition  will  call  me  from  this  state  of  apathy,  and  arm 
me  with  resolution  to  overcome  all  opposition.  Thus, 
you  see,  my  friend,  my  condition  appears  to  be  prepon- 
derating between  hope  and  despair.  At  present,  hope 
appears  rather  to  prevail.  I  am  doing  business  in  two  or 
three  of  the  best  families  in  town.  .  .  . 

"  On  Saturday  last,  you  will  conclude  I  was  somewhat 
surprised,  upon  receiving  the  following  lines  from  Dr. 
Smith  :  '  Sir,  —  The  executive  authority  of  Dartmouth 
College  have  appointed  you  to  deliver  an  oration  on  some 
medical  subject,  on  the  next  anniversary  Commencement- 
day.  Nathan  Smith.' 

"  My  ambition  is  great ;  but  my  diffidence  and  conscious 
inability,  I  believe,  will  prevent  my  accepting  the  appoint- 
ment.    It  is  true,  if  I  should  undertake  the  performance 


CORRESPONDENCE.  51 

and  meet  with  general  approbation,  it  would  be  a  fine 
thing  for  me  ;  but,  if,  on  the  contrary,  I  should  fail  of 

pleasing,   it  would me.      Then,   candor  would 

make  allowance  for  adolescence  and  inexperience.  You 
know  me  and  my  situation  :  therefore  be  so  kind  as  to 
give  me  your  advice  upon  the  subject." 

"  Norwich,  Vt.,  June  19,  1805. 

"  Friend  Carter,  —  Yours  of  the  10th  instant  was  duly 
received,  wherein  you  expressed  a  decided  opinion,  that 
it  would  be  best  for  me  to  attempt  a  medical  performance 
on  Commencement-day.  I  think  your  remarks  upon  the 
subject  were  just ;  yet,  I  believe,  you  were  not  exactly  ac- 
quainted with  my  situation.  You  must  know,  that  I  shall 
have  to  write  a  dissertation,  to  be  read  at  my  examination, 
which  will  be  six  weeks  previous  to  Commencement ;  — 
this  will  employ  my  attention  until  the  examination. 
And,  as  I  am  attending  to  chemical  lectures,  I  shall  not 
have  time  to  write  a  dissertation  which  would  answer  for 
an  oration.  Thus,  I  shall  have  only  the  six  weeks  which 
intervene  between  examination  and  Commencement  to 
write  an  oration  and  commit  it.  Another  objection 
which  occurs  is  the  extra  expense  I  must  be  at  for  clothes 
proper  to  appear  upon  the  stage.  And,  indeed,  some- 
times I  think  I  will  not  take  a  degree,  as  it  will  be  un- 
certain whether  I  can  command  cash  sufficient ;  and,  at 
the  best,  I  shall  have  to  involve  myself  to  the  amount  of 
what  cash  I  then  need. 

"  My  business,  since  I  wrote  last,  has  rather  exceeded 
my  expenses ;  yet  that  is  no  object  to  a  person  so  much 
in  debt  as  I  am.  Now,  the  question  is,  whether  it  would 
be  prudent  for  me  to  borrow  twenty  dollars,  which  I  shall 
expend,  if  I  take  the  degrees  of  M.B.  and  A.M.  But, 
....  it !  why  am  I  troubling  you  with  my  complaints  ? 


52  CORRESPONDENCE. 

I  shall  be  as  well  off  a  thousand  years  hence  as  anybody. 
You  say  you  will  attend  Commencement,  if  I  pronounce 
an  oration  :  that  need  not  make  any  difference  with  you. 
I  shall  be  just  as  happy  to  see  you  if  I  do  not,  and  you 
will  be  much  better  entertained.  Now,  I  shall  depend 
upon  seeing  you  and  Mrs.  Carter  here  at  that  time.  With 
regard  to  the  oration,  I  shall  think  no  more  about  it  till 
I  have  completed  my  dissertation ;  then,  perhaps,  I  may 
turn  my  attention  that  way.  In  the  mean  time,  do  write 
often.  Name  some  subject  that  would  be  proper  for  a 
medical  oration,  if  I  should  conclude  to  write.  From 
what  I  have  written,  you  will  conclude  I  am  nearly 
insane,  and  in  fact  your  conclusions  will  not  be  far  from 
accurate  ;  for  you  know  that  it  is  written,  '  Dull  thinking 
will  make  a  man  crazy.'  Yours,  Amos  Twitchell. 
"  Dr.  David  Carter. 

"  X.  B.  — I  give  you  many  thanks  for  taking  that  note 
T  gave  brother  Timothy  ;  and  perhaps  it  will  be  well  for 
you  to  endorse  them  on  it,  as  you  will  never  get  any 
thing  else." 

"Norwich,  August  7,  1805. 
"  Friend  Carter,  —  When  I  wrote  by  Mr.  Cutter,  it 
was  in  such  haste  that  I  omitted  mentioning  my  deter- 
mination with  respect  to  taking  degrees  the  ensuing  Com- 
mencement. In  your  letter  of  the  10th  ultimo,  you 
kindly  offer  me  your  pecuniary  assistance,  if  I  should 
need.  But  I  am  already  so  much  indebted  to  you,  I  dare 
not  accept  your  offer.  A  few  days  previous  to  my  exami- 
nation, I  visited  the  president,  —  told  him  I  had  almost 
determined  not  to  take  my  degrees,  on  account  of  the  ex- 
pense. He  told  me  I  need  not  give  myself  any  trouble 
with  respect  to  his  fees  ;  he  would  wait  till  I  could  make 
it  convenient  to  pay  them.     Dr.  Smith  likewise  made  me 


CORRESPONDENCE.  53 

the  same  offer,  upon  which  I  concluded  to  go  forward. 
So,  I  believe,  I  will  not  be  obliged  to  you  for  any  more 
cash  till  my  necessity  shall  be  more  urgent. 

"  With  respect  to  my  oration,  after  I  completed  my 
dissertation,  which  was  only  the  day  before  my  exami- 
nation, I  began  to  turn  my  attention  that  way.  But  I 
have  had  so  much  business  since,  that  I  have  not  pro- 
gressed far.  At  present  I  have  not  much  business ;  but 
I  anticipate  some  soon.  As  it  is  but  three  weeks  to  Com- 
mencement, it  is  very  uncertain  whether  I  shall  be  able  to 
complete  an  oration  and  commit  it. 

"  I  shall  put  the  greatest  dependence  upon  seeing  you 
and  Mrs.  Carter  at  Commencement.  I  have  a  great  many 
things  I  want  to  say  to  you ;  and,  if  a  man  in  your  situa- 
tion cannot  afford  himself  the  pleasure  of  such  a  journey, 
J  am  surely  living  for  nought.  .  .  .  Accept  of  the  fullest 
assurance  of  respect  and  gratitude  from  your  friend  and 
servant,  Amos  Twitchell. 

"  Dr.  David  Carter." 

The  oration  was  never  delivered ;  but  the  young 
physician  took  his  degrees  of  A.M.  and  M.B.  in  regu- 
lar academic  course,  in  1805. 


54 


CHAPTER   IV 


FROM    1505    TO   1310.  JET.   -24— -20. 


Mother's  Death.  —  Correspondence  with  Dr.  Carter.  —  Prospects. 
—  Despondency.  —  Anecdote.  —  Influence  of  Dr.  Smith.  — 
Removal  to  Marlborough.  —  Operation  of  tying  Carotid.  —  His- 
tory of  the  Subject.  —  Views  of  Contemporary  Surgeons,  Du- 
puytren,  Rous,  Abernethy,  Sir  Astley  Cooper,  &c.  —  Several 
Minds  always  work  towards  one  Discovery.  —  Number  of  Times 
the  Operation  had  been  performed.  —  General  Results.  — 
Twitchell  to  be  placed  in  the  first  ranks  of  Surgery  for  this 
Case. 

Ox  November  12,  1805,  Dr.  TwitchelTs  excellent 
mother  died.  She  had  been  for  years  suffering  with 
a  most  painful  and  malignant  disease.  He  had  been 
anticipating  the  event,  as  a  moment  of  release  for  a 
dear  parent  from  a  life  of  great  torture.  He  met 
it  with  calmness,  and,  I  doubt  not,  joy.  Who  would 
not  wish  for  death  to  come,  if  it  will  bring  peace 
to  a  loved  one  who  is  a  hopeless  sufferer  ?  Nothing 
but  selfish  nature  could  greet  that  mysterious  power, 
under  such  circumstances,  otherwise  than  as  the 
choicest  of  heavenly  blessings.  It  might  have  been 
said,  at  her  death,  in  the  beautiful  words  of  the 
modern  poetess,  — 

"  And,  friends  !  dear  friends  !  when  it  shall  be 
That  this  low  breath  is  gone  from  me, 
And  round  my  bier  ye  come  to  weep,  — 


CORRESPONDENCE.  00 

Let  one,  most  loving  of  you  all, 
Say,  '  Not  a  tear  must  o'er  her  fall ; 
He  giveth  His  beloved  sleep  ! '  " 

The  following  letter  refers  to  the  event :  — 

"  Hanover,  N.H.,  Dec.  18,  1805. 

"Friend  Carter, — Yours  of  the  13th  ultimo  was  duly 
received,  which  gave  me  the  unwelcome,  though  not 
unexpected,  intelligence  of  a  mother's  death.  Filial  affec- 
tion bids  me  sorrow ;  but  philosophical  reflection  forbids, 
saying  this  is  only  an  unavoidable  event  in  the  revo- 
lution of  nature.  You  well  know  my  ideas  with  regard 
to  such  things :   therefore  I  will  not  enlarge 

"  I  have  of  late  had  the  happiness  to  form  an  acquaint- 
ance with  Dr.  Cowdery,  who  was  a  surgeon  on  board  the 
'Philadelphia'  frigate,  when  captured  by  the  Tripolitans. 
He  now  is  visiting  his  friends  in  Tunbridge,  Vt.  I  find  him 
to  be  a  very  fine  gentleman :  he  appears  to  be  a  man  of 
good  information,  as  it  respects  his  profession.  I  was 
very  much  pleased  with  his  company ;  he  repeated  many 
circumstances  of  his  captivity,  —  the  manners,  customs, 
&c.  of  Tripolitans,  some  of  which  you  undoubtedly  have 
seen  in  his  journal,  which  is  now  publishing  in  many  of 
the  newspapers  in  the  United  States 

"  Dr.  D.  Carter."  "  Amos  Twitchell. 

I  will  here  group  together  extracts  from  further 
letters  to  the  same  correspondent,  as  they  will  afford 
us  a  better  idea  of  his  actual  condition,  during  his 
residence  at  Norwich,  than  any  general  description 

I  can  give  :  — 

"Norwich,  Vt.,  April  4,  1806. 
"  Friend  Carter,  —  Yours  of  the  25th  ultimo  was  gladly 
received.     It  gave  me  pleasure  to   learn   that  you  were 


56 


CORRESPONDENCE. 


giving  B the  privilege  of  a  good  school ;   but  you 

did  not  inform  me  who  her  preceptor  was.  But,  sir,  it 
was    with   regret   that   I  believe   you,  when  you  say  E. 

L is   dead.      I  am  sure   you  do  not  submit  to  let 

death  pass  unmolested  among  your  neighbors,  and  seize 
upon  the  most  promising  of  your  citizens.  I  like  your 
observations  well  respecting  Dr.  Rush  :  I  am  informed 
that  he  has  published  a  new  edition  of  his  works,  which 
undoubtedly  are  much  improved. 

"  With  respect  to  myself,  it  is  now  a  year  since  I  came 
into  this  town.  My  business,  including  my  services  at  the 
College,  has  amounted  to  about  250  dollars,  which  is 
trifling  ;  yet,  considering  the  healthiness  of  the  place, 
and  the  multitude  of  physicians,  it  is  doing  as  well  as 
could  be  expected  .... 

"  Amos  Tavitchell." 

"  Norwich,  June  1,  1806. 
"  Friend  Carter,  —  It  is  a  long  time  since  I  wrote  you, 
but  have  had  no  return.  I  resume  my  pen  once  more. 
Since  I  wrote  you  last,  my  business  has  been  tolerably 
good,  —  in  April  last  I  charged  upwards  of  thirty  dollars, 
in  May  above  forty,  —  and  still  seems  to  be  increasing. 
But  it  still  remains  a  doubt  in  my  mind,  whether  it  is 
best  for  me  to  remain  in  this  place.  I  am  confident  I 
shall  obtain  the  chief  of  the  business,  if  I  do.  Yet 
I  believe  I  might  do  more  elsewhere.  My  other  prospects 
are  about  the  same  as  they  were  when  I  saw  you  last. 
Dr.  Smith  advises  me  to  tarry.  O has  been  endeavor- 
ing to  persuade  me  to  go  with  him  into  York  State ;  he 
says  he  will  carry  out  about  fifteen  hundred  dollars,  and 
go  into  some  eligible  place  and  open  an  apothecary  store, 
and  we  will  share  equally  in  the  profits  of  the  store  and 
our  practice.     You  know  my  hobby,  and  I  should  like  to 


CORRESPONDENCE.  57 

converse  with  you  upon  the  subject.  I  have  a  desire 
to  go  to  Philadelphia,  and,  ambition  would  even  say,  to 
Europe.  However,  I  will  drop  this  subject.  I  believe  I 
shall  see  you  before  winter,  when  I  will  explain  to  you 
fully. 

"  I  have  a  number  of  interesting  cases  I  should  like  to 
relate  to  you  ;  but  they  are  lengthy.  Of  course  I  must 
omit  them,  and  will  barely  mention  to  you,  that,  about 
five  weeks  since,  I  operated  upon  a  fistula  lachrymalis, 
which  had  been  of  ten  years'  standing,  and  succeeded  to 
a  charm.  Next  week,  I  shall  operate  upon  another.  My 
mode  of  operating  is   agreeable  to  Ware,  which  differs 

considerably  from  Bell 

"  Amos  Twitchell." 

"Bemis's  Room,  Hanover,  Nov.  26,  1806. 

"  Friend  Carter,  — ....  It  has  been  suggested  to  me 
by  a  number,  that  they  were  desirous  I  should  visit  your 
part  of  the  country,  and  bring  my  knives.  Your  study 
has  been  named.  If  it  should  meet  your  approbation,  I 
should  willingly  sacrifice  something  to  the  advantage 
I  think  you  might  derive.  They  would  not  wish  you  to 
take  any  part  in  the  transaction,  neither  would  they 
molest  any  within  your  circuit. 

"  That  ....  doctor  from  Norwich  might  excite  some 
suspicions  in  your  neighborhood  ;  but  he  has  become 
so  hardened  in  iniquity,  that  he  will  pay  no  regard  to 
them  except  on  your  account.  If  you  think  such  a  pro- 
cedure would  injure  you  more  than  the  benefit  you  should 
derive  from  it,  I  think  we  had  best  desist.  At  least,  be 
pleased  to  express  your  opinion  upon  the  subject. 

"  It  would  not  be  necessary  for  me  to  be  with  you  more 
than  a  week  or  ten  days  at  farthest.  .  .  . 

"  Amos  Twitchell." 


58  CORRESPONDENCE. 

"Norwich,  Feb.  14,  1807. 
"  Friend  Carter,  —  I  have  not  heard  from  you  since  my 
remembrance,  but  still  hope  you  are  living.  I  yesterday 
received  a  letter  from  Mr.  William  P.  Cutter,  of  JafFrey, 
informing  me  that  Dr.  Abner  Howe  has  left  Jaffrey,  and 
commenced  business  in  Beverly,  Mass.  He  likewise 
expressed  a  desire  to  come  and  tarry  with  me  till  he  had 
completed  his  study.  I  should  be  proud  enough  of  taking 
a  pupil,  provided  I  had  a  sufficient  library  of  my  own, 
and  was  sure  of  continuing  in  this  place  any  considerable 
length  of  time.  But,  sir,  I  am  not  perfectly  satisfied  with 
my  situation.  It  is  true,  my  circuit  enlarges ;  yet  the 
emoluments  of  my  practice  appear  rather  too  small ;  and 
my  future  prospects  are  such  (provided  they  should  equal 
my  expectation),  they  would  hardly  warrant  me  in  spend- 
ing the  prime  of  my  life,  before  I  could  attain  to  any  thing 
like  independence.  It  must  be  a  number  of  years  before 
I  can  entirely  extricate  myself  from  debt.  On  the  other 
hand,  a  future  day  presents  many  allurements  to  entice 
me  to  persevere.  Thus  I  remain  in  suspense,  doubtful 
which  way  to  direct  my  course.  I  was  in  hopes  of  seeing 
you  ere  this  time,  that  I  might  disclose  to  you  my  views 
at  large.  But  I  could  not  do  it  without  much  sacri- 
fice. .  .  .  "Amos  Twitchell." 

"Norwich,  April  29,  1807. 
"Friend  Carter,  —  Yours  of  the  17th  instant  has  been 
duly  received  ;  but  my  present  avocations  must  be  my 
excuse  for  delaying  an  answer  till  some  future  communi- 
cation. What  I  wish  now  is  you  would  give  me  your 
advice  in  an  affair  of  consequence.  Yesterday  a  friend  of 
mine  called  upon  me,  and  informed  me  that  he  had  an 
affair  of  honor  to  settle  with  a  person,  who  had  insulted 
him  in  a  public  manner :    consequently,  he  had  invited 


CORRESPONDENCE.  59 

him  to  visit  Canada,  where  they  could  adjust  the  affair  in 
safety.  He  has  not  had  a  return  as  yet ;  but  the  proba- 
bility is,  that  the  invitation  will  be  accepted.  My  friend 
told  me  he  should  depend  on  me  as  his  second ;  but  I 
told  him  I  should  utterly  refuse  him.  He  then  said  he 
would  excuse  me,  provided  I  would  attend  him  as  his 
surgeon.  Now,  sir,  be  so  kind  as  to  inform  me  immedi- 
ately, whether  it  would  be  improper  for  me  to  attend  him. 
They  are  both  gentlemen  of  the  first  character  and  stand- 
ing in  society.  My  friend  ranks  high  as  a  military 
character.  —  Yours,  sir,  in  haste, 

"Amos  Twitchell." 
"  P.S.     Don't  tell  the  old  gentleman,  my  father,  of  this. 
You  shall  hear  from  me  soon." 

"Norwich,  May  9,  1807. 
"  Friend  Carter,  —  ...  With  regard  to  leaving  Norwich, 
I  have  not  as  yet  had  Dr.  Smith's  advice  upon  the  subject. 
Not  having  had  an  opportunity  of  conversing  with  him,  I 
have  barely  mentioned  it  to  him.  But  I  have  pretty 
much  concluded  to  quit.  I  have  been  looking  over  my 
books.  I  find  I  am  doing  very  poorly  :  some  have  run 
away ;  others  are  unable  to  pay ;  and  not  any  of  them 
do  pay.  Of  course,  I  shall  never  be  able  to  make  remit- 
tances to  my  creditors,  so  long  as  I  tarry  here.  .  .  . 

"  Amos  Twitchell." 

"Norwich,  August  16,  1807. 
"  Friend  Carter,  —  You  undoubtedly  think  it  very 
strange  that  I  do  not  visit  you ;  but  business  has  been 
such,  I  have  thought  it  best  to  delay  the  journey  as  yet. 
I  have,  since  the  reception  of  the  money  you  sent,  charged 
to  the  amount  of  seventy  dollars.  I  think,  as  Com- 
mencement is  so  nigh  at  hand,  I  shall  not  be  down  till 
after  it  has  past.     You  then  may  calculate   to   see  me. 


60  ANECDOTE. 

Your  pupils,  B and  L ,  have  called  upon  me,  and 

inform  me  that  a  young  Esculapian  has  erected  his  stand- 
ard in  Jaffrey.  What  he  is  I  do  not  learn.  Perhaps  he 
may  render  my  success  doubtful :  I  can  tell  better  when  I 
see  him.  When  you  see  him,  tell  him  he  may  calculate 
upon  my  coming  to  Jaffrey.  —  After  customary  compli- 
ments, I  would  in  haste  subscribe  myself,  your  much 
obliged  and  very  humble  servant, 

"Amos  Twitchell." 

During  his  residence  at  Norwich,  we  perceive  by 
his  letters  that  at  times  he  suffered  from  great  des- 
pondency. Once  this  increased  to  a  very  great 
degree,  as  the  following  anecdote,  related  a  few  years 
ago  by  him  to  myself,  satisfactorily  proves.  It  gives 
us  also  a  nearer  insight  to  the  relations  existing  be- 
tween Dr.  Smith  and  Dr.  Twitchell,  while  at  the 
same  time  it  shows,  in  a  clear  light,  the  sagacious 
good  sense  of  the  preceptor,  and  his  willingness  to 
forget  himself  for  the  sake  of  his  beloved  pupil. 

Darkness  had  been  resting  over  the  thoughts  of 
the  young  physician  for  many  days.  He  sat  alone, 
brooding  over  his  fate,  which,  as  he  thought,  was 
destined  to  deceive  all  those  who  loved  him.  Even 
Dr.  Smith  wras  mistaken  in  him.  It  was  impossible 
to  succeed.  He  had  few  patients,  and  still  fewer 
hopes  of  having  any.  At  length,  he  confined  him- 
self wholly  to  his  chamber,  and  sternly  refused  to 
see  even  those  who  called  professionally  upon  him. 
When  urged  by  those  at  whose  house  he  resided 
to  send  for  Dr.  Smith,  or  some  other  physician,  he 
angrily  refused,  saying  he  needed  no  medical  atten- 
dant.     Finally,  however,  the  alarmed  family  sent 


ANECDOTE.  61 

over  to  the  professor,  and  informed  him  of  the  circum- 
stances, and  likewise  of  Dr.  Twitchell's  absolute 
refusal  to  see  any  physician,  even  himself.  The  next 
day,  at  early  morning,  Smith  entered  the  room  of 
the  hypochondriac,  and  the  following  pointed  dia- 
logue took  place  between  them  :  — 

Twitchell.  —  What  brought  you  here  ? 

Smith.  —  I  was  making  my  circuit,  and  it  brought 
me  near  to  you  ;  and,  as  I  wanted  you  to  make 
for  me  some  ....  (a  chemical  preparation,  of  which 
the  name  is  forgotten),  that  you  used  to  prepare  when 
a  student,  I  thought  I  would  ask  you  to  go  home  with 
me,  and  make  a  little,  and,  at  the  same  time,  teach 
my  students  the  art. 

Twitchell.  —  I  can  H  go. 

Smith.  —  But  I  cannot  listen  to  any  refusal.  You 
must  go.  Besides,  I  mean  to  show  you  a  very  severe 
case  of  gun-shot  wound,  that  I  met  with  a  few  days 
since. 

Twitchell.  —  I  repeat,  sir,  I  cannot  go. 

"  But  at  the  same  time,"  as  he  told  me,  "  the 
memory  of  former  kindnesses  smote  my  heart,  and 
immediately  I  felt  that  I  ought  not  to  refuse.  Un- 
willingly, therefore,  I  consented,  and  prepared  for 
the  journey.  Dr.  Smith  said  nothing  ;  satisfied  with 
having  gained  the  point  of  removing  me  from  my 
own  apartment.  We  were  soon  in  the  carriage,  and 
my  companion  was  in  his  liveliest  humor.  He  told 
me  of  every  thing  he  was  doing,  of  all  his  cases,  of 
the  private  jokes  of  the  neighborhood  ;  and  all  with 
the  same  earnestness  as  he  would  have  done,  had  I 
taken  the  warmest  interest  in  the  tales. 
6 


62  ANECDOTE. 

"Arrived  at  Hanover,  I  was  kept  hard  at  work  all 
day  in  the  laboratory,  making  chemicals  and  teach- 
ing the  students  until  dark. 

"Smith  then  came  home,  and  thanked  me  very 
much  for  what  I  had  done,  and  then  said,  'It  is  too 
late  to  think  of  returning  now.  You  will  pass  the 
night  here.'  I  protested  in  vain.  '  Besides,'  said 
he,  '  there  is  that  patient  I  told  you  about:  we  must 
get  up  early  to-morrow  morning,  and  go  and  see 
him.'  Unwillingly,  again,  I  yielded;  and  the  next 
day,  at  early  dawn,  we  were  in  the  chaise.  I  ob- 
served the  doctor  had  his  gun  with  him,  but  presumed 
that  his  love  of  sporting,  which  he  had  gained  in  his 
youth,  was  the  cause  of  it.  We  visited  two  or  three 
patients,  and  drove  farther  and  farther  away  from 
home.  About  dinner-lime  we  stopped  at  a  country 
inn.  "We  took  dinner,  and,  when  we  had  finished, 
it  was  proposed  to  the  landlord,  that  he  should  put 
up  some  turkeys  for  us  to  shoot  at.  The  afternoon 
passed  away  rather  more  pleasantly.  We  spent  the 
whole  of  it  in  sporting,  and  my  mind  was  taken 
from  the  fixed  and  morbid  contemplation  of  my  own 
thoughts.  Evening  came,  and  we  were  still  far 
from  home ;  and  the  result  was  another  night's  so- 
journ at  Dr.  Smith's,  and  another  prospect  of  a  ride 
in  the  morning.  The  next  day,  we  started  again  ; 
and,  as  we  were  driving  over  hill  and  dale,  I  re- 
member as  vividly  as  possible  how  suddenly  it 
flashed  upon  me,  that  Smith,  my  honored  master, 
had  been  thus  devoting  two  whole  days  to  cure  me 
of  a  mere  mental  hallucination.  I  felt  thoroughly 
ashamed  of  mvself  at  the  idea.      The  charm  was 


TYING    OF    THE    CAROTID    ARTERY.  63 

broken.  I  knew  he  had  been  reading  me  all  the  while, 
and  I  had  been  behaving  like  a  fool.  We  were  ra- 
pidly driving  down  hill,  and  Smith  was  talking  as 
usual,  when  I  burst  into  a  broad  horse-laugh.  Smith 
turned,  with  his  keen,  kind  glance,  and  said,  'Well, 
what's  the  matter  now  ?'  'I  have  been  thinking,'  I 
replied,  i  what  a  fool  you  must  have  thought  me. 
I  feel  heartily  ashamed  of  myself.'  t  I  rather  think 
you  will  be  able  to  go  home  to-night,'  shrewdly 
replied  my  friend.  From  that  moment  I  was  a  new 
man ;  and  ever  after,  if  I  looked  sad,  Smith  would 
bring  me  up  to  a  right  frame  of  mind,  by  asking 
whether  it  would  not  be  well  to  go  to  Hanover  to 
make  chemicals." 

In  the  latter  part  of  1807  or  first  of  1803,  Dr. 
Twitchell  removed  to  Marlborough,  the  residence  of 
his  brother-in-law  Dr.  Carter,  with  whom  he  entered 
into  partnership.  It  was,  moreover,  understood  at 
the  time  that  he  came  for  the  purpose  of  devoting 
himself  chiefly  to  surgery. 

About  the  time  of  Dr.  Twitchell's  leaving  Nor- 
wich, and  settling  at  Marlborough,  he  performed  an 
operation,  which  has  been  justly  deemed  the  crown- 
ing glory  of  his  early  fame  as  a  surgeon.  I  allude 
to  his  tying  of  the  common  carotid  artery,  —  one  of 
the  main  blood-vessels  leading  to  the  brain.  As  this 
case  has  given  rise  to  some  discussion,  I  propose 
to  examine  the  subject  a  little  in  detail.  I  would 
premise,  that,  from  experiments  made  upon  the 
horse  and  some  other  of  the  inferior  animals,  Dr. 
Twitchell  had  become  convinced  that  the  main  ar- 
teries, going  to  the  brain,  could  be  closed  without 


64  TYING    OF    THE    CAROTID    ARTERY. 

injury  to  their  life.    He  had  not  the  same  confidence 
in  regard  to  human  beings. 

In  the  month  of  October,  1807,  a  young  lad, 
named  Taggart,  had  his  jaw  shattered  by  a  pistol- 
shot.  All  the  adjacent  parts  were  severely  bruised, 
and  extensive  mortifications  of  them  occurred.  On 
the  tenth  day  after  the  injury,  while  dressing  it, 
Dr.  Twitchell  observed  that  one  of  the  mortified 
parts  lay  directly  over  the  carotid.  The  mother  of 
the  lad,  an  aged  woman,  was  standing  near,  as  the 
sole  attendant ;  and  he  remarked  to  her,  "  If  that  spot 
goes  through  the  coats  of  the  vessel,  your  son  may 
bleed  to  death  in  a  very  few  minutes."  In  a  paper 
on  the  subject,  afterwards  published,  he  says:  — 

"  I  applied  the  usual  dressings,  left  the  room,  and  was 
about  leaving  the  house,  when  some  one  of  the  family 
cried  out  that  he  was  bleeding.  I  hastened  back  to  his 
room,  and  found  him  deluged  with  blood.  The  dressings 
were  immediately  removed,  and  the  blood  jetted  forcibly, 
in  a  large  stream,  to  the  distance  of  three  or  four  feet. 
With  the  thumb  of  my  left  hand,  I  instantly  compressed 
the  artery  against  the  base  of  the  skull,  and  thus  ef- 
fectually controlled  the  hemorrhage.  The  patient  had 
fainted  ;  and  fifteen  or  twenty  minutes  had  elapsed  before 
he  was  so  much  revived  that  I  dared  to  make  any  attempt 
to  secure  the  artery.  Then,  still  keeping  the  thumb 
firmly  pressed  on  the  orifice,  I  proceeded  to  clear  the 
wound  from  blood  ;  and,  having  done  this,  I  made  an  in- 
cision, with  a  scalpel,  downward,  along  the  course  of  the 
artery,  to  more  than  an  inch  below  the  point  where 
the  external  branch  was  given  off ;  which,  as  stated 
above,  had  been  destroyed  at  the  time  of  the  injury. 
Having  but  one  hand  at  liberty,   I   depended  upon   the 


TYING    OF    THE    CAROTID    ARTERY.  65 

mother  of  the  patient  to  separate  the  sides  of  the  wound ; 
which  she  did,  partly  with  a  hook  and  occasionally  with 
her  fingers.  At  length,  partly  by  careful  dissection  and 
partly  by  using  my  fingers  and  the  handle  of  the  scalpel, 
I  succeeded  in  separating  the  artery  from  its  attachments  ; 
and,  passing  my  finger  under  it,  I  raised  it  up  sufficiently 
for  my  assistant  to  pass  a  ligature  round  it.  She  tied  it 
with  a  surgeon's  knot,  as  I  directed,  at  about  half  an  inch 
below  the  bifurcation. 

"  I  removed  my  thumb  and  sponged  away  the  blood,  not 
doubting  that  the  hemorrhage  was  effectually  controlled. 
But,  to  my  surprise  and  disappointment,  the  blood  imme- 
diately began  to  ooze  from  the  rupture  in  the  artery ;  and 
in  less  than  ten  minutes  it  flowed  with  a  pulsating  jet.  I 
compressed  it  again  with  my  thumb,  and  began  to  de- 
spair of  saving  my  patient.  What  further  could  I  do  ? 
It  was  impossible  to  apply  a  ligature  above  the  orifice  : 
compression,  then,  was  the  only  alternative.  How  was 
that  to  be  effected  ?  Should  some  one  sit  by  the  patient, 
and  compress  the  artery  constantly  with  the  fingers  till 
adhesion  should  take  place  ?  Possibly  that  might  have 
been  done ;  but  I  resolved  to  make  another  attempt  first. 
Raising  my  thumb,  I  placed  a  small  piece  of  dry  sponge 
directly  over  the  orifice  in  the  artery  ;  and,  renewing  the 
compression  till  a  little  larger  piece  of  sponge  could  be 
prepared,  I  placed  that  upon  the  first ;  and  so  went  on, 
pressing  the  gradually  enlarged  pieces  obliquely  upwards 
and  backwards  against  the  base  of  the  skull,  till  I  had 
filled  the  wound  with  a  firm  cone  of  sponge,  the  base  of 
which  projected  two  or  three  inches  externally.  Then 
I  applied  a  linen  roller  in  such  a  manner  as  to  press 
firmly  upon  the  sponge ;  passing  it,  in  repeated  turns, 
over  the  head,  face,  and  neck.  I  directed  that  the  patient 
should  be  placed  in  bed,  with  his  head  moderately  raised, 
6* 


66  TYING    OF    THE    CAROTID    ARTERY. 

and  that  he  should  be  kept  as  quiet  as  possible  ;  and,  as 
his  pulse  was  very  feeble,  he  having  lost  at  that  time 
between  three  and  four  pounds  of  blood  by  estimation, 
he  was  allowed  a  little  wine  and  water,  and  occasionally 
some  broth.  We  carefully  watched  him  through  the 
night ;  but  no  bleeding  occurred,  and  he  complained  of 
but  little  pain." 

The  patient  recovered.* 

No  one,  I  think,  can  read  this  account  without 
being  struck  with  the  decision  and  masterly  surgical 
power  evinced  by  the  operator.  And  yet  he  never 
published  any  report  of  the  fact,  until  persuaded  to  do 
so,  many  years  afterwards ;  and  he  yielded  then  to 
the  urgency  of  a  friend,  who  wanted  an  article  for  a 
medical  journal. f  His  nephew,  Dr.  Bemis  of  Med- 
ford,  to  whose  active  kindness  in  procuring  data  for 
this  memoir  I  owe  very  much,  writes  as  follows: 
"His  unwillingness  this  case  should  be  published, 
with  others  I  had  drawn  up,  was  partly  for  the 
reason,  if  I  remember  rightly,  that  the  operation  had 
been  in  some  degree  forced  upon  him  in  this  in- 
stance by  the  circumstances,  which  left  him  no  op- 
tion. Besides,  before  the  time  of  putting  his  notes 
in  order,  he  had  heard  of  Mr.  Fleming's  case  ;  %  and 
this  increased  the  unwillingness  he  had  to  publish  his 

*  For  a  full  account  of  this  case,  see  Appendix  B. 

t  XeTv  England  Quarterly  Journal  of  Medicine  and  Surgery, 
vol.  i.  p.  188. 

%  Let  it  be  remembered,  that  Dr.  Twitchell  operated  in  1807. 
Mr.  Fleming  operated  in  1803,  but  did  not  publish  until  1817. 
Dr.  Bemis  arranged  Dr.  Twite-hell's  notes  in  1837 — 8,  after  the  ope- 
ration of  tying  the  carotid  had  become  an  every-day  occurrence. 


OPINIONS    OF    SURGEONS    THEREUPON.  67 

own,  lest  he  should  seem  to  claim  the  credit  of  ori- 
ginating the  operation." 

Now,  I  contend  that  this  operation,  done  at  that 
time,  was  most  admirable ;  and  that,  if  Dr.  Twit- 
chell  had  chosen  then  to  publish  the  case,  he  would 
have  gained,  by  that  single  act,  a  European  fame, 
which  his  subsequent  life  never  would  have  belied. 
In  order  to  prove  this,  let  us  pass  in  review  the  exact 
state  of  medical  opinions  upon  the  subject,  and  the 
amount  of  knowledge  as  to  the  propriety  of  tying 
the  carotid,  which  had  descended  to  us  from  the 
earliest  ages  of  surgery. 

And  first,  to  classical  scholars,  as  all  great  sur- 
geons were  until  the  present  century,  during  which 
classical  studies  have  been  undeservedly  neglected 
by  medical  men,  the  very  signification  of  the  word 
"carotid"  must  have  suggested  ideas  of  death.  It 
is  derived  from  Jta^oco,  to  cause  to  sleep ;  because 
the  earliest  professors  of  our  art  proclaimed  that 
animals  fell  into  a  deep  sleep,  usually  the  precursor 
of  death,  whenever  the  great  blood-vessels  leading 
to  the  brain  were  tied.  The  opinion  was  founded 
more  on  theory  than  absolute  demonstration.  It 
was,  however,  a  fixed  and  sacred  law  of  surgery, 
that,  if  the  artery  was  tied,  the  brain  would  not 
receive  its  accustomed  stimulus  —  the  blood,  and 
that  death  would  result. 

Another  opinion  had  likewise  prevailed  until  the 
latter  part  of  the  last  century,  viz.  that  it  would  be 
dangerous  to  the  nutrition  of  any  part,  if  the  main 
artery  leading  to  it  were  tied.  A  priori,  this  would 
seem  natural ;  but  the  genius  of  John  Hunter  had 


68  HUNTER,  KENDRICK,  AND  ROUX. 

proved,  in  1785,  that  the  main  artery  of  the  leg 
could  be  tied  without  destroying  the  nourishment  of 
it ;  and,  by  that  proof,  he  brought  to  light  one  of  the 
most  beautiful  of  God's  laws  which  can  be  observed 
in  the  animal  organization,  viz.  that  usually  only  a 
few  hours  elapse,  before  the  smaller  arteries  enlarge, 
and  take  the  place  of  the  main  trunk  which  has  been 
shut  up.  This  great  English  surgeon  first  proposed 
to  tie  the  artery  in  the  thigh,  for  disease  in  the  ham. 
This  was  thought  a  bold  proposal.  Now  it  is  univer- 
sally admitted  to  be  correct,  and  the  operation  is  suc- 
cessfully done.  None,  however,  suggested  operating 
upon  the  neck  in  this  way,  because  of  the  fear  of 
trouble  in  the  brain,  and  death.  Even  as  late  as 
1807,  Kendrick*  does  not  mention  the  tying  of  the 
carotid  for  aneurism. 

Roux,  the  eminent  French  surgeon,  in  his  "  Me- 
langes," f  published  in  1809,  i.  e.  two  years  after 
Twitchell  had  successfully  tied  the  carotid,  does  not 
allude  to  the  possibility  of  doing  so. 

Still  further,  I  am  informed  by  an  eminent  sur- 
geon of  this  city,  that,  even  as  late  as  1809,  much 
doubt  was  felt  by  surgeons  generally,  in  this  coun- 
try, as  to  the  possibility  of  tying  even  the  compa- 
ratively small  artery  of  the  arm.  [Moreover,  Du- 
puytren,  who  for  a  quarter  of  a  century  was  the 
chief  of  French  surgery,  performed  in  1813  (six 
years  after  Twitcheil's  case)  the  operation  of  tying 
the  carotid,  as  Sir  Astley  had   done  for  aneurism. 

*  Edinburgh  Medical  and  Physical  Dictionary. 

t  Melanges  de  Chirurgie  et  Physiologie,  Paris,  1809. 


HEBENSTREIT    AND    ABERNETHY.  (39 

It  was  done,  however,  not  in  the  presence  of  the 
class,  but  in  private,  with  a  select  few,  and  as  a 
"  great  operation."  These  facts  show  the  views  of 
Twilchell's  chief  cotemporaries  on  the  subject. 

As,  in  every  other  grand  discovery  in  any  branch 
of  learning,  no  one  man  reveals  the  whole  ;  but 
several  minds  work,  while  all  tend  towards  the  same 
end,  until  finally  one  proclaims  boldly  what  the 
others  have  prophesied  merely  :  so  was  this  idea  of 
tying  the  carotid  gradually  emerging  from  the  dark- 
ness of  preceding  centuries  of  surgery,  and  was 
destined  to  be  fully  brought  out  into  a  bright  light 
by  the  genius  and  courage  of  Sir  Astley  Cooper.  Its 
history  is  as  follows :  Hebenstreit,  a  German  sur- 
geon, seems  to  have  been  the  first  to  mention  a 
successful  case.  The  operation  was  performed  on 
account  of  a  wound  in  the  vessel,  produced  during 
the  removal  of  a  scirrhous  tumor  from  the  neck. 
The  patient  lived.  As  there  is  probably  no  edition* 
of  this  work  in  America,  we  might  safely  conclude, 
even  if  we  had  no  other  evidence,  that  our  friend 
never  knew  of  the  fact. 

Next  came  the  renowned  English  surgeon,  Aber- 
nethy,f  who,  in  1804,  first  published  a  case,  almost  a 
fac-simile  of  that  of  Dr.  Twitchell.  A  man  had  been 
gored  by  an  ox,  and  the  carotid  was  injured  in  its 
branches.  Evidently  fearing  at  first  to  tie  the  main 
artery,  Mr.  Abernethy  closed  the  superficial  vessels. 
Finding  the  blood  still  flowed,  he  felt  compelled,  as 
Dr.  Twitchell  did  three  years  afterwards,  to  lie  the 

*  German  Translation  of  Benjamin  Bell's  Surgery, 
t  Surgical  Observations,  1801. 


70  FLEMING    AND    SIR    ASTLEY    COOPER. 

vessel,  as  a  mere  chance  to  prevent  immediate  death. 
The  patient  died,  and  the  brain  was  affected ;  so  that 
this  case,  if  Twitchell  had  known  of  it,  would  rather 
have  tended  to  support  the  idea  above  mentioned,  viz. 
that  a  ligature  upon  the  carotid  would  disturb  the 
cerebral  functions,  and  cause  death.  It  appears, 
however,  that  Dr.  Twitchell  knew  nothing  of  it. 

In  1803,  Mr.  Fleming,  a  naval  English  surgeon, 
tied  the  vessel  in  a  man  who  had  attempted  suicide. 
The  patient  was  saved.  This  case  was  not  published 
until  1817.* 

Contemporaneous  with  this,  November,  1803,  was 
an  operation  of  the  same  kind,  by  a  surgeon  of  our 
own  country.f  A  tumor  was  removed  from  the  neck 
by  Dr.  Cogswell,  of  Connecticut;  and,  during  the 
operation,  the  carotid  was  necessarily  cut  and  tied. 
Twenty  days  after  the  operation,  the  patient  died 
from  slight  hemorrhage.  This  fact  was  likewise  not 
published  until  years  had  elapsed.  So  that  Dr. 
Twitchell  could  not  have  known  of  it,  save  by  hear- 
say ;  and  there  is  positive  evidence,  viz.  his  own 
assertion,  that  he  knew  nothing  of  it.  According  to 
Yelpeau4  Dubois  had  prepared  to  perform  the  ope- 
ration in  1804 ;  but  the  patient  suddenly  died  on  the 
evening  previous  to  the  proposed  time. 

November  1,  1805,  Sir  Astley  Cooper  operated 
for  aneurism  of  the  carotid.  The  patient  died, 
although  Sir  Astley  did  not  give  up  the  hope  that 

*  Cooper's  Surgical  Dictionary.     Article  :  Aneurism, 
f  Lectures  Introductory  to  Medical  Course  of  Instruction  at 
Yale  College,  by  Jonathan  Knight.     1838. 
X  Surgery,  Mott's  edition. 


INFERENCES.  71 

the  operation  might,  under  favorable  circumstances, 
be  performed.  He  was  nevertheless  obliged  to  wait 
until  the  successful  and  brilliant  result  of  a  second 
operation  in  1808  (one  year  after  Dr.  Twitchell  had 
operated  successfully),*  before  he  could  prove  the 
feasibility  of  tying  this  vessel  with  perfect  safety 
to  life.  He  did  not  publish  the  result  of  this  case 
until  1809.  f 

The  foregoing  statements,  I  think,  will  sustain  me 
in  the  following  propositions :  — 

1.  The  general  voice  of  surgery  was  against  any 
attempt  to  tie  the  carotid  artery,  at  the  time,  October, 
1807,  that  Dr.  Twitchell  successfully  tied  that  artery. 

2.  Although  some  cases  had  occurred  in  the  hands 
of  a  few  surgeons,  there  is  evidence  that  all  except 
one  (Abernethy's)  could  not  have  been  known  to  Dr. 
Twitchell  in  a  published  form,  when  he  operated  on 
Taggart.  Moreover,  as  Abernethy's  case  proved 
fatal,  and  only  confirmed  all  previous  fears  on  the 
subject,  it  would  hardly  have  induced  any  one  to 
follow  the  example. 

*  Sir  Astley,  in  remarking  upon  this  case,  says  :  "Ina  profes- 
sional point  of  view,  it  was  very  desirable  to  ascertain  the  possibi- 
lity of  saving  life  in  a  case  that  had  hitherto  proved  fatal,  viz. 
aneurism  of  the  carotid ;  and  I  could  not  but  feel  more  than  com- 
mon interest  in  the  fate  of  a  man,  who,  although  he  well  knew 
that  the  trial  was  new  and  the  risk  considerable,  never  betrayed 
the  smallest  signs  of  apprehension."  AVherein  consists  the  "  de- 
sirableness "  in  this  case  ?  Aneurism  of  the  extremities  had  been 
cured  by  tying  arteries.  It  was  a  settled  point.  The  question 
with  Sir  Astley  doubtless  was,  whether  the  same  operation  that  had 
been  successful  in  the  leg  could  be  done  upon  the  neck  with  safety 
to  life. 

t  Medico- Chirurgical  Transactions,  vol.  i.     1809. 


72  RANK    OF    TWITCHELL. 

3.  We  have  the  positive  assertion  of  Dr.  Twitch  ell, 
that  he  was  ignorant  of  the  vessel  having  ever  been 
tied  by  any  one,  although,  from  his  own  experiments 
on  animals,  he  had  been  led  to  suspect  that  it  could 
be  safely  closed  in  men. 

Why,  then,  should  he  not  stand  in  the  same  rank 
with  Abernethy  and  Fleming,  so  far,  at  least,  as  one 
operation  shows  the  calibre  of  a  man's  mind  ?  Cer- 
tainly he  deserves  thus  much.  Led  by  his  native 
sagacity,  his  fertility  of  resources  under  difficulties, 
and  by  his  previous  experiments,  he  performed  what 
a  man  of  smaller  intellect  and  less  fortitude  would 
have  considered  as  impossible.  By  that  decision 
and  boldness  he  saved  a  human  life  !  I  would  not 
willingly  claim  any  thing  more  than  properly  belongs 
to  him ;  but  really,  when  I  think  that  he  performed 
the  operation,  contrary  to  many  of  his  early  medical 
prejudices,  at  the  risk  of  his  own  fame,  while  un- 
assisted save  by  "an  old  woman"  (as  he  told  me) 
"  to  wax  his  thread,  and  holding  on  with  one  hand 
to  arrest  the  hemorrhage  from  the  open  spouting 
artery,  while  with  the  other  he  dissected  down,  and 
displayed  its  trunk,"  —  when  I  review  all  these 
embarrassing  circumstances,  and  see  how  nobly  he 
arose  above  them,  I  feel  a  most  cordial  respect  for 
his  surgical  genius,  and  regard  him  as  one  of  the  true 
nobility  of  our  profession.  In  saying  this,  I  would 
not  detract  an  iota  from  the  fair  fame  of  either  of  his 
contemporaries.  There  need  be  no  discussion  of 
their  relative  claims.  They  were  all  discoverers, 
and  deserve  equal  praise.  Sir  Astley  Cooper  arose 
at  a  fortunate  time  to  proclaim  that  the  carotid  artery 


RANK    OF    TWITCHELL.  73 

could  be  tied  to  cure  aneurism  ;  but,  if  he  had  not 
done  so,  it  were  very  easy  to  prove  that  some  others 
would  have  soon  done  it ;  for  the  general  principles 
laid  down  by  John  Hunter  must,  sooner  or  later, 
have  led  surgeons  to  this  result. 

Newton  was  born,  it  has  been  said,  at  a  lucky 
time  to  discover  gravitation.  Others  were  just  upon 
the  point  of  doing  the  same  thing.  Leibnitz  con- 
tends with  the  geometer  for  the  honor  of  having 
discovered  the  principles  of  the  calculus  ;  and  the 
scientific  world  grants  to  each  equal  honor,  because 
each,  by  his  own  unaided  efforts,  brought  out  his 
beautiful  result.  Leverier  and  Adams  stand  side  by 
side  in  the  temple  of  honorable  fame.  Why  should 
not  the  same  just  rule  of  estimating  a  man's  true 
reputation  be  followed  now,  and  Twitcheli's  name 
be  put  at  least  by  the  side  of  those  of  Abernethy  and 
Cooper  ?  This  is  all  I  claim,  —  that  he  should  be 
in  the  front  rank  of  the  hosts  of  modern  surgery. 
More  especially  do  I  claim  such  rank  for  him,  because 
this  brilliant  case  was  only  the  harbinger  of  a  series 
of  triumphs  of  his  surgical  skill,  which  extended 
through  a  period  of  over  forty  years. 

I  return  now  to  his  biography.  He  had  made  a 
contract  with  his  brother,  Dr.  Carter,  to  stay  with 
him  for  a  certain  period.  As  that  period  drew  near 
to  its  termination,  Dr.  Twitchell  seems  to  have  felt 
that  a  larger  sphere  was  needed  for  his  powers.  He 
wished  likewise  to  cultivate  his  own  mind  still  more, 
by  a  further  attendance  on  some  medical  school. 

The  following  letter  is  in  answer  to  one  written  to 
him  by  a  resident  in  Rockingham  :  — 
7 


74  INVITATION    TO    ROCKINGHAM. 

"  Marlborough,  N.H.  Jan.  10,  1809. 

"  Dear  Sir, —  Your  polite  letter  of  the  14th  ult.  has 
been  duly  received.  You  mention  the  loss  you  have  sus- 
tained by  the  death  of  Dr.  Levi  Sabin.  From  what  little 
acquaintance  I  have  had  with  the  man,  and  with  his 
character  as  a  physician,  I  conclude  your  vicinity  will  sin- 
cerely lament  his  death,  and  the  faculty  will  feel  the  loss 
of  a  worthy  member. 

"  I  feel  very  sensibly  the  honor  you  do  me  in  offering  me 
your  patronage,  with  the  assurance  of  that  of  the  principal 
inhabitants  of  Rockingham,  provided  I  will  make  that  my 
permanent  residence.  True,  sir,  I  do  not  consider  myself 
permanently  settled  in  this  place.  My  contract  with  my 
brother  will  expire  in  one  year  from  the  first  day  of  the 
present  month ;  after  which,  I  have  not  determined  upon 
any  particular  residence.  I  should  like  Rockingham  on 
many  accounts ;  yet  I  believe  I  should  not  be  so  well 
situated  there  for  the  practice  of  surgery  as  I  am  now.  I 
should  have  Dr.  Goodhue  on  one  side ;  and  I  believe,  on 
the  other  side,  Dr.  Badger,  of  "Westminster,  is  attempting 
something  in  that  line  :  how  he  will  succeed  I  cannot 
tell.  It  is  very  probable  that  you  will  be  supplied  before 
the  termination  of  my  contract ;  at  which  time  I  have  it 
in  contemplation  to  visit  some  medical  school,  the  better 
to  deserve  the  patronage  of  the  public.  This  suggestion, 
however,  I  would  not  wish  to  have  made  public. 

"  Thus,  sir,  I  have  given  you  a  brief  sketch  of  my 
views,  from  which  you  will  learn  that  it  is  not  in  my 
power  to  comply  with  your  request  at  present."' 


75 


CHAPTER   V. 


FROM    1810    TO    1815.  JET.   29—34. 


Removal  to  Keene.  —  Even  Tenor  of  Life.  —  Practice.  —  "  Spotted 
Fever."  —  Independence  of  Twitchell.  —  Dislike  of  Nosologies. 

—  Letter  from  Dr.  Carter.  —  New  Hampshire  Medical  Society, 
Member,  1811.  —  Offices  held  by  him  during  Life.  —  President, 
&c.  —  Orator.  —  Engagement  to  Miss  Goodhue.  —  Correspond- 
ence. —  Practice.  —  Assemblies  at  Keene.  —  Pupils.  —  News 
of  Peace.  —  Rejoicings.  —  Horseback  Rides.  —  Marriage,  1815. 

—  Character  of  Mrs.  Twitchell.  —  Influence  on  her  Husband.  — 
Death,  1848.  —  Effect  of  her  Death  on  Dr.  Twitchell. 

In  1810  Dr.  Twitchell  went  to  Keene,  from  which 
place  he  never  removed,  although,  as  we  shall  see, 
he  had  not  a  few  invitations  so  to  do.  There  he 
labored  for  about  forty  years,  gradually  rising  to  a 
fame  of  which  any  one  might  have  been  proud. 
For  years,  I  may  say  it  without  for  one  moment 
seeming  to  underrate  any  other  practitioner,  he  stood 
literally  at  the  head  of  the  profession  throughout  that 
portion  of  our  country.  He  was  also  known,  by 
correspondence  on  medical  cases,  to  most  of  the 
ablest  men  in  all  parts  of  the  United  States.  Never- 
theless, the  whole  of  his  life  flowed  onward  in  a 
quiet  and  even  tenor,  —  always  active,  yet  never 
unduly  excited ;    so  that,   though  we  may  see  the 


76  LIFE    AT    KEENE. 

result  ill  the  solid  fame  which  he  acquired,  it  will 
present  in  its  recital  no  striking  passages. 

Slowly  and  amid  many  tribulations,  as  we  have 
already  in  some  measure  seen,  did  his  strong  mind 
develop  itself.  We  can  but  dimly  trace  its  progress, 
though  we  may  feel  it  when  comparing  one  epoch 
with  another.  I  shall  speak  of  his  life  at  Keene 
under  various  heads,  among  which  I  shall  weave 
whatever  of  correspondence  I  can  gather. 

We  have  brief  records  of  all  his  operations  per- 
formed between  1808-14.  This  record  was  made 
in  1842,  according  to  the  dictation  of  Dr.  Twitchell, 
from  his  day-book.  It  is  unfortunate  that  these  notes 
are  not  taken  more  in  detail ;  but,  meagre  as  they 
are,  they  prove  that  at  that  period  he  must  have  been 
well  known  ;  for,  out  of  between  ninety  and  a  hun- 
dred operations,  many  of  them  are  the  most  impor- 
tant in  surgery. 

Within  a  year  or  two  after  he  commenced  practice 
in  Keene,  the  "  spotted  fever,"  so  called,  began  to 
appear  as  an  epidemic ;  and  a  panic  was  the  result. 
The  country  practitioners  in  general  might  be  divided 
into  two  classes ;  viz.  the  learned,  who  were  bound 
hand  and  foot  to  their  nosologies,  and  who  con- 
sidered it  of  infinite  importance  to  name  and  classify 
a  disease  before  commencing  treatment ;  and  the 
grossly  ignorant,  who,  though  independent  of  the 
shackles  of  classifications,  were  disposed  to  treat 
all  cases,  which  they  supposed  to  be  spotted  fever,  in 
one  and  the  same  way.  Twitchell's  native  vigor  of 
mind  came  gloriously  into  play  on  this  occasion ; 
and   he  gained  much  reputation  for  his  successful 


SPOTTED    FEVER.  77 

treatment  of  this  alarming  complaint.  Feeling  that 
the  idea  of  the  necessity  of  classification,  in  order  to 
a  proper  treatment,  had  been  carried  to  an  absurd 
extent,  he  renounced  the  doctrine.  He  would  give 
no  name,  but  would  treat  symptoms  as  they  arose. 
If  a  man  were  burning  with  fever,  he  would  prescribe 
ice ;  if  shivering  with  cold,  he  would  stimulate  until 
fever  came  on,  and  then  have  recourse  again  to  refri- 
gerants. All  this  seems  very  sensible,  according  to 
our  present  medical  theories ;  yet,  such  is  the  power 
of  habit,  he  was  considered  somewhat  singular  in  his 
day.  His  course  was,  however,  in  fact  the  really 
wise  combination  of  the  heroic  and  expectant  treat- 
ments. The  following  letter,  from  his  witty  brother- 
in-law  Dr.  Carter,  so  quietly  informs  us  of  the 
absurdities  of  the  profession,  and  the  alarm  created 
by  the  appearance  of  the  disease,  that  I  cannot  for- 
bear quoting  it :  — 

"Marlborough, 28,  1810. 

"  Friend  Twitchell,  —  After  hearing  very  alarming  ac- 
counts from  the  frequency  of  the  spotted  fever  at  Fitzwil- 
liam,  I  had  the  curiosity  to  go  down  there  this  morning 

to  learn  of  Drs.    ,  ,  and  ,  the  symptoms 

as  it  appeared  with  them.   I  had  the  good  luck  to  find  them 

all  at  home.     Dr.  is  unwell.     Perhaps  they  would 

say  he  is  convalescing  ;  therefore  I  made  not  much  inquiry 
of  him,  except  as  the  monster  attacked  him,  and  the  treat- 
ment, &c.     Dr. has  had  all  the  violent  cases,  —  he 

thinks  to  the  amount  of  twenty  cases ;  and  I  think  it  pro- 
bable he  has  been  called  to  twenty  patients  that  have 
complained  of  something.  But  I  cannot  learn  to  my 
satisfaction  that  there  has  been  a  single  case  in  Fitz- 
7* 


73  NEW    HAMPSHIRE    MEDICAL    SOCIETY. 

williara.  They  make  it  appear  like  a  hundred-headed 
monster,  attacking  in  every  form  imaginable :    therefore 

they  have    no    other    complaints.      Dr.  tells    me, 

that  he  has  not  bled,  puked,  nor  purged  for  three  weeks 
past ;  but  gives  from  ten  to  fifteen  grains  of  opium,  once 
in  three  or  four  hours,  for  forty-eight  hours  ;  at  which  time 
he  begins  to  lessen  his  doses,  and  tapers  down ;  and  by 
that  time  they  are  safe.     Queer  complaint  indeed ! 

"  You  had  better  go  down,  and  learn  how  to  make  all 
anomalous  complaints  put  on  one  and  the  same  type,  and 
yield  to  one  and  the  same  treatment :  it  will  save  you 
much  thinking  in  future. 

"  If  they  have  had  a  case  of  it,  I  have  no  doubt  but  I 
have  had  several ;  but  I  am  not  so  fortunate  as  to  make 
brandy  and  opium  cure  mine,  therefore  am  put  to  the 
trouble  of  thinking  a  little  before  I  prescribe. 

"To  be  serious,  I  had  rather  have  the  spotted  fever  in 
Fitzwilliam  than  the  itch  ;  for  I  should  rather  drink 
brandy  freely  than  roast  with  brimstone.  —  Yours, 

"  D.  Carter." 

In  1811  Dr.  Twitchell  was  chosen  a  member  of 
the  New  Hampshire  Medical  Society,  and  from  that 
time  until  death  always  felt  the  liveliest  interest  in 
it.  He  was,  as  a  friend  writing  to  me  says,  "  the 
idol  of  the  association."  In  1815  he  was  elected 
one  of  the  censors ;  subsequently,  in  1823,  became 
a  counsellor.  Each  of  these  offices  he  held  several 
years.  For  three  years  from  1S27,  he  was  its  presi- 
dent. On  some  of  these  occasions  he  read  scientific 
papers.*  In  1833  he  was  orator.  Later  he  was 
elected  to  represent  the  society  in  the  American 
*  See  Appendix,  B,  E,  H. 


MARRIAGE.  79 

Medical  Association,  and  the  convention  for  the  re- 
vision of  the  Pharmacopoeia.  It  is  interesting  to 
notice,  that,  although  he  had  probably  more  business 
than  any  other  physician  in  New  Hampshire,  he 
almost  invariably  attended  the  meetings  of  each  and 
all  of  these  societies.  This  doubtless  arose  in  part 
from  his  social  qualities  ;  but  he  had  higher  reasons. 
His  confidence  was  great,  that  by  these  unions  we 
elevate  the  profession.  Wherever  man  meets  with 
man  in  friendly  interchange  of  thought,  nay,  Ave  may 
sav  that  wherever  a  human  being  meets  another  with 
a  kindly  look,  even  if  no  words  be  spoken,  by  that 
very  contact  and  that  look  the  two  are  benefited  and 
elevated  in  the  scale  of  human  existence.  None  but 
a  misanthrope  thinks  otherwise.  Dr.  Twitchell  was 
no  hater  of  his  race. 

Some  time  in  the  early  part  of  1314  or  latter  por- 
tion of  1813,  Dr.  Twitchell  became  interested  in  the 
excellent  woman  who  subsequently  became  his  wife. 
She  was  the  daughter  of  Dr.  Josiah  Goodhue,  of 
whom  we  have  already  spoken,  as  the  chief  surgeon 
previously  to  Dr.  Smith's  appearance  at  Hanover. 
As  usual,  the  course  of  true  love  did  not  run  with 
entire  smoothness,  and  Dr.  Twitchell's  letters  evince 
great  anxiety  lest  clouds  may  come  to  overshadow 
their  fair  prospects.  Occasionally,  he  lets  forth 
his  thoughts  in  scraps  of  quoted  poetry,  which,  to 
those  of  us  who  knew  him  in  later  days,  seem  as 
incongruous  with  his  nature  as  the  idea  of  a  philoso- 
pher flirting  with  a  lady's  fan.  We  find  allusions  to 
his  increasing  practice,  which  prevents  the  lover  from 
leaving  his  post,  especially  in  1814,  when  the  typhus 


80  CORRESPONDENCE. 

fever  seems  to  have  been  very  prevalent.  Under 
date  of  Feb.  23,  1814,  he  says,  "  The  cries  of  dis- 
tress have  prevented  me  from  being  with  you  this 
evening,  and  are  likely  to  prevent  for  days  to  come." 
He  then  states  that  he  had  been  called  that  day  to 
several  cases  of  fever,  and  describes  the  panic  which 
had  seized  the  friends.  On  another  occasion  he 
pleads  the  same  difficulty  of  constant  and  perplexing 
business,  as  a  reason  why  he  cannot  write  so  often  as 
he  would  like.  Dr.  Twitcheli's  letters  I  do  not  feel 
at  liberty  to  quote  from  very  freely.  They  are 
models  of  the  quiet,  affectionate  expression  of  an 
honest  and  unimaginative  mind  to  a  woman  whom  it 
loves  sincerely.  Reason  is  the  governing  power. 
Love-rhapsodies  are  unknown.  On  the  death  of  her 
sister,  he  tries  to  support  her  heart  by  the  follow- 
ing :  "  It  is  the  duty  of  rational  beings  not  to  make 
themselves  miserable  at  events  which  are  beyond 
their  reach  to  control,  but  with  a  calm  resignation  to 
consider  that  He  who  governs  the  universe  orders 
every  thing  for  the  good  of  the  whole." 

Under  date  of  January  1st,  I  find  as  follows  *.  — 

"  I  hope  my  expectations  are  governed  by  reason,  al- 
ways keeping  in  view  the  frailty  of  human  nature,  and 
endeavoring  as  much  as  possible  to  smooth  the  asperities 
of  life  by  an  equanimity  of  temper.  .  .  .  Last  Tuesday 
evening,  we  had  an  assembly,  or  an  assemblage.  I  went 
at  half-past  eight,  and  was  called  away  at  nine  ;  so  you 
see  that  my  enjoyment  or  suffering  could  not  be  great.  .  .  . 
I  am  now  called  to  visit  a  patient  at  JafFrey  this  evening, 
the  distance  of  fifteen  miles.  To  prevent  being  lone- 
some, I  shall  carry  you  with  me.      I  cannot  say  how  you 


CORRESPONDENCE.  81 

will  like  the  ride ;  but,  as  you  are  not  here  to  refuse,  I 
don't  see  how  you  can  help  yourself;  and,  as  the  vulgar 
saying  is,  I  will  do  as  much  for  you  some  time. 

"  Yours  affectionately,  "  Amos  Twitchell." 

The  above  is  almost  the  sole  specimen  of  even  a 
disposition  to  be  jocose  while  writing  to  Miss  Good- 
hue. 

It  appears  by  one  letter,  that  he  has  already  a 
class  of  students  :  — 

"Oct.  28,  1814. 

"  Yours  of  the  24th  was  received  with  pleasure.  The 
contemplated  visit  will  give  me  pleasure,  if  it  be  in  my 
power  to  be  of  the  party,  which  shall  be  my  endeavor. 
My  pupils  have  all  left  me  to  attend  lectures  at  Xew 
Haven ;  *  and  I  have  this  day  performed  a  very  important 
surgical  operation ;  and,  whether  it  will  be  safe  to  leave 
the  patient  at  that  time,  I  cannot  say ;  but  you  may  cal- 
culate upon  seeing  me,  unless  very  urgently  detained.  .  .  . 
Believe  me  when  I  tell  you,  that  I  sincerely  join  in  your 
supplication  that  we  may  have  entire  confidence  in  each 
other's  lasting  friendship  and  affection." 

"Feb.  19,  1815. 
"  Dear  Elizabeth,  —  Your  promised  letter  has  not  ar- 
rived. I  conclude  that  William  has  not  passed  through 
this  town,  and  you  are  waiting  for  a  few  of  my  scrawls 
before  you  send  it  by  mail.  You  shall  have  them.  Time 
passes  with  me  much  as  usual,  —  much  engaged  in 
business,  and  constantly  anticipating  future  enjoyments. 
Last  Tuesday,  about  eleven  o'clock  a.m.  we  received 
the  joyful  news  of  peace  being  concluded  between  our 
minister  and   the   British.       You    scarcely   can    conceive 

*  Dr.  Smith  was  transferred  to  New  Haven  in  Oct.  1813. 


82  PEACE    WITH    GREAT    BRITAIN. 

what  effect  it  produced  upon  all  classes  of  people  in  this 
place.  Business  was  entirely  neglected.  The  bell  was 
kept  constantly  ringing  from  the  time  the  news  arrived 
until  ten  o'clock  in  the  evening ;  and  there  was  a  good 
deal  of  powder  burnt  upon  the  occasion.  In  the  even- 
ing, we  had  a  very  splendid  illumination  of  all  the 
houses,  shops,  and  stores,  with  the  meeting-house  and 
court-house.  The  next  day,  the  street  was  very  much 
thronged  with  people  from  the  vicinity,  who  assembled 
here  to  learn  the  foundation  of  the  news,  and  rejoice  with 
each  other.  They  kept  the  bell  ringing  most  of  the  time 
this  day  also.  Parker's  company  of  light  infantry,  and 
Perry's  company  of  cavalry,  turned  out  in  uniform.  We 
are  all  waiting  anxiously  to  hear  that  the  president  has 
signed  the  treaty."  *  .  .  . 

I  presume  that  this  description  of  the  intense  joy 
with  which  news  of  peace  was  received  by  all  parties 
in  Keene,  is  only  a  slight  exemplification  of  the  great 
and  unanimous  voice  of  exultation  which  arose  on 
that  occasion  from  every  quarter  of  our  common 
country.  Each  party  seemed  to  vie  with  the  other 
in  the  utterance  of  the  joyful  hopes  of  peace. 

Here  is  another  specimen  of  his  country  surgeon's 
life,  under  date  of  March  1,  1815 :  — 

"  Had  I  the  poetic  talents  of ,  I  might  amuse 

you  with  the  description  of  my  tour  to  Stoddard  yester- 
day. I  met  with  as  many  disasters  as  he  did  in  his 
sleigh-ride,  when  he  '  came  across  back  from  Pomfret  to 
the  Sound  on  horseback.'  In  short,  I  found  such  snow- 
drifts, that  I  was  obliged  to  leave  my  horse,  and  travel  on 

*  Peace  had  been  concluded  at  Ghent,  Dec.  12,  1814. 


COUNTRY   RIDING.  83 

foot  three  miles  out  and  back  again.  I  was  very  much 
fatigued,  and  took  some  cold  ;  but  I  have  felt  so  well 
to-day  that  I  have  ridden  thirty  miles  on  horseback ! " 

The  next  letter  is  chiefly  occupied  with  details  of 
arrangements  for  housekeeping,  and  anxieties  natu- 
ral to  these  new  hopes.  The  riding  seems  still  to  be 
any  thing  but  agreeable.     He  writes  thus  :  — 

"We  have  had  so  bad  riding  in  this  vicinity,  that  I 
have  delayed  visiting  Chester,  hoping  that  it  would  soon 
be  better ;  though  there  is  scarcely  a  day  passes  that  I  do 
not  ride  thirty  miles.  Yet,  after  dashing  through  mud 
that  distance,  I  am  not  in  a  situation  to  enjoy  comfort. 
If  the  roads  do  not  become  passable  for  a  chaise  soon,  I 
shall  take  the  stage  and  visit  you." 

In  the  early  part  of  June,  1815,  the  worthy  couple 
were  married  ;  and,  for  more  than  thirty-three  years, 
they  enjoyed  life  together  in  the  quiet  daily  progress 
of  their  wedded  state.  Mrs.  Twitchell  had  an  active 
mind,  which  was  almost  wholly  absorbed  in  domestic 
duties,  and  in  thoughtfulness  for  her  husband.  Her 
life  was  one  unbroken  tissue  of  devotion  to  him  who 
was  her  glory.  It  has  been  thought  by  some  who 
were  warm  admirers  of  both,  that  her  great  anxiety 
for  his  physical  well-being  did  not  tend  to  develop 
some  of  the  finer  qualities  of  his  mind.  This  remark, 
however,  applies  more  to  the  influences  exerted  by 
her  upon  the  husband's  relations  to  the  world  than 
to  their  own  married  state.  No  man,  I  believe,  ever 
had  a  wife  who  sought  more  to  make  home  a  haven 


^4  MRS.    TWITCHELL. 

of  rest  and  of  gentle  quiet,  after  long  and  severe 
labors.  The  moment  Dr.  Twitchell  entered  the 
house  was  the  signal  for  her  quiet  but  efficient 
energy  to  display  itself  in  behalf  of  his  comfort. 
All  sounds  were  hushed,  and  the  repose  of  his 
body  and  mind  was  considered  paramount  to  every 
thing  else.  Unquestionably,  this  entire  rest  was 
at  times  necessary.  It  doubtless  contributed  to  his 
health  and  long  life ;  and  we  should  therefore  be 
chary  of  suggesting  that  any  other  course  would 
have  been  better.  It  is  possible  that  his  excessive 
bodily  toil,  combined  with  his  great  love  of  social 
intercourse,  might  have  for  ever  prevented  him  from 
directing  much  time  to  literary  labor.  His  natural 
indisposition  to  writing  was,  however,  fostered  even 
by  the  good  qualities  of  his  wife,  as  evinced  in 
this  constant  and  untiring  watchfulness  for  his  com- 
fort. Had  she  been  otherwise  constituted,  it  is 
possible  that  his  life  might  have  been,  it  is  true,  less 
happy,  and  perhaps  it  would  have  been  shorter; 
but  he  would  have  had  a  wider  influence  and  a  more 
enduring  fame.  If,  instead  of  constantly  suggesting 
quiet  sleep  for  body  and  mind  on  his  return  from 
business,  she  had  gently  led  him  to  overcome  his 
repugnance  to  writing, —  had  she  stimulated  him,  as 
any  truly  beloved  woman  can  stimulate  a  man,  with 
a  desire  for  literary  reputation,  —  it  is  possible  that 
Dr.  Twitchell  would  have  left  in  print  a  work  upon 
which  our  profession  in  future  time  might  have 
looked  with  great  pride,  as  upon  a  monument  really 
significant  of  his  intellectual  power.  No  compre- 
hensive work  on  surgery,  such  as  a  mind  like  his,  and 


HOME    INFLUENCE.  85 

with  his  ample  opportunities  should  have  left,  ever 
issued  from  his  pen.  Comparatively  speaking,  his 
life  dies  with  him. 

I  make  these  remarks  with  some  sorrow;  but, 
recognizing  the  mighty  influence  of  woman  on  man's 
destiny,  I  cannot  do  otherwise ;  for  the  records  of 
biography,  and  the  deductions  of  reason,  alike  prove 
that  the  marriage-vow  should  not  chiefly  promote 
the  repose  of  husband  or  of  wife,  but  should  tend  to 
elevate  both.  While  alluding  thus  to  a  wife  who 
was  so  beloved  by  our  departed  friend,  let  me  add 
that  regret  is  merged  in  pleasure  at  the  thought,  that, 
though  her  nature  did  not  lead  her  to  the  hope  of 
literary  reputation  for  her  husband,  she  seemed 
verily  to  worship  the  great  traits  of  his  manly  charac- 
ter. By  that  adoration,  her  life  was  made  one  con- 
tinued series  of  self-sacrificing  tenderness  and  love. 
Her  uniform  quiet  cheerfulness  was  frequently  his 
support.  She  was,  moreover,  a  model  of  a  physi- 
cian's wife,  in  the  care  and  many  kindnesses  with 
which  she  ministered  to  those  who  called  to  consult 
him.  If  he  were  absent,  Mrs.  Twitchell  knew  how 
to  bestow  upon  them  those  thousands  of  apparently 
unimportant  attentions  a  loving  wife  will  give,  when 
she  thinks  substantial  good  will  result  therefrom  to  a 
dear  husband's  cause. 

Growing  up  thus  together,  year  after  year,  their 
ties  became  more  and  more  close,  so  that  at  last  they 
seemed  inseparable,  and  all  who  knew  them  felt  that 
to  take  one  from  the  other  would  shatter  the  heart  of 
the  survivor.  For  many  years,  the  wife  looked 
anxiously  at  the  husband,  who  seemed  slowly,  but 


^G  wife's   death. 

surely,  wending  his  way  to  the  tomb  with  malignant 
disease.  Yet,  so  strange  are  the  mutations  of  this 
life,  the  husband  recovers  from  his  disease,  and  the 
wife  is  stricken  down  suddenly  from  his  side.  She 
died  of  lung  fever,  October,  1848.  Dr.  Twitchell 
was  wholly  prostrated  by  his  loss,  and  for  hours  he 
was  afflicted  with  one  of  his  severe  fits  of  despond- 
ency. At  length,  however,  his  stern  reason  tri- 
umphed, and  he  came  forth  again  among  his  fellows. 
He  resumed  his  rides  over  his  beautifully  romantic 
native  hills.  Nature  spoke  to  him,  as  of  old,  of  an 
all-powerful,  all-beneficent  Being ;  and  he  submitted 
cheerfully  to  his  lot.  Those  who  knew  him  inti- 
mately tell  me,  that  they  think  he  was  never  quite 
himself  again.  So  far  as  his  life  was  concerned, 
"  the  golden  bowl  was  broken,  and  the  pitcher 
broken  at  the  fountain."  He  assumed  many  duties 
which  wrere  new  to  him  in  the  domestic  arrange- 
ments, and  the  current  of  his  existence  appeared  to 
go  onward  in  its  accustomed  routine  of  daily  profes- 
sional labors. 

In  speaking  thus  of  Mrs.  Twitchell,  in  order  to 
condense  into  one  passage  every  circumstance  that 
it  was  important  to  relate  concerning  her,  I  have  an- 
ticipated my  story.     I  will  now  return  to  it. 

Among  his  papers,  I  find  the  following  letter,  which 
I  transcribe  as  somewhat  indicative  of  his  charac- 
ter: — 

(Tom  off)  18,  1818. 

"Rev.  Sir, — As  you  have  long  been  the  friend  and 
acquaintance  of  my  wife's  connections  in  Chester,  it  is 
her  wish,  together  with  mine,  that  you  or  Mrs. would 


CORRESPONDENCE.  87 

be  so  kind  as   to  give  to  N B the  intelligence 

that  her  sister  Elizabeth,  who  has  resided  with  us,  and 
been  the  delight  of  our  eyes,  died  this  morning  a  quarter 
before  eight  o'clock.     She  was  attacked  two  weeks  since 

with   a  complaint  of  the  head.  ...  As  N is  a  child 

of  great  sensibility,  we  concluded,  as  you  were  intimately 
acquainted  with  her,  that  you  would  be  the  most  suitable 
person  to  give  her  the  information.  ...  In  complying  with 
the  above  request,  you  will  confer  a  great  favor  upon  your 
afflicted  friend,  "  Amos  Twitchell. 

" ,  Esq." 


CHAPTER   VI. 


FROM    1815   TO   1849 jET.   34- 


Offered  a  Professorship  at  Dartmouth  College,  1819  ;  at  Vermont 
Academy  of  Medicine,  1824  ;  at  Castleton,  1826 ;  at  Bowdoin 
College,  1826.  —  Invited  to  reside  at  Boston. — Trepannning 
of  Tibia.  —  Preceded  by  Sir  Benjamin  Brodie.  —  Extensive 
Bides.  —  Dangers  ;  Labors.  —  Circular  to  Patients.  —  Letter 
to  a  Young  Friend.  —  Temperance.  —  Anecdotes.  —  Youths  at 
the  Tavern.  —  Tobacco-chewing.  —  Farmer  and  his  Corn.  — 
Visit  to  Philadelphia  as  Temperance  Delegate.  —  Anecdote.  — 
Temperance  Addresses  less  successful  than  his  Conversation, 
—  Temperance  Documents.  —  Politics.  —  Asylum  for  Insane. — 
American  Medical  Association ;  Origin  ;  Interest  of  Dr.  Twit- 
chell  in  its  "Welfare ;  Delegate  to  its  Meeting. 

In  the  spring  of  1819,  Dr.  Twitchell  received  over- 
tures from  gentlemen  belonging  to  the  Medical 
Faculty  of  Dartmouth  College,  in  regard  to  his  ac- 
ceptance of  a  professorship,  which  was  about  to 
beome  vacant. 

I  find  the  following  letter  thereupon  :  — 

"June  28,  1819. 
"Rev.  and  dear  Sir,  —  Your  polite  letter  of  the  17th 
instant  was  duly  received.  I  have  maturely  considered 
the  propositions  therein  contained,  and  have  consulted 
some  friends  upon  the  subject;  and  have  come  to  the 
conclusion,  that  to  accept  of  a  professorship  under  the 
circumstances  which  Dr. proposed  would  be  making 


HANOVER    PROFESSORSHIP.  s9 

too  great  a  pecuniary  sacrifice.  Were  it  probable  that 
I  could  discharge  the  duties  of  the  station  in  a  suitable 
manner,  and  that  the  emolument  would  be  sufficient  to 
indemnify  me  for  the  sacrifice  of  business  and  extra  ex- 
pense attending  so  long  an  absence  from  my  family,  I 
would  cheerfully  accept  of  the  appointment;  but  I  am 

fully  convinced  that  would  not  be  the  case.     Dr.  

informed  me  that  the  fees  of  each  professor  heretofore  have 
averaged  about  one  thousand  dollars,  a  greater  part  of 
which  would  be  students'  notes,  which,  in  my  hands, 
would  not  be  worth  fifty  per  cent.  Besides,  I  am  appre- 
hensive that  the  number  of  students  will  be  less  than  for 
several  years  past.  All  those  in  this  vicinity,  who  have 
money  to  defray  the  expense,  are  calculating  upon  attend- 
ing lectures  either  at  Boston  or  New  Haven.  Had  you 
sufficient  funds  to  give  your  professors  a  suitable  salary, 
they  would  be  more  useful  to  the  institution  by  devoting 
their  time  and  talents  exclusively  to  its  promotion;  but 
circumstanced  as  you  are,  when  the  only  salary  you  can 
afford  your  medical  professors  is  what  they  can  obtain 
from  young  men  who  are  struggling  hard  with  poverty  in 
the  pursuit  of  their  profession,  it  cannot  be  expected  that 
any  one  situated  as  I  now  am  should  feel  willing  to 
accept  of  the  office.  I  should  anticipate  much  pleasure 
in  being  connected  with  a  literary  institution,  no  small 
share  of  which  would  arise  from  a  personal  intercourse 
with  its  officers  and  other  literary  men.  But  the  uncer- 
tainty of  health  and  life  is  such  that  I  consider  it  a  duty 
I  owe  to  myself  and  my  connections  to  devote  my  time 
and  talents  to  the  pursuit  of  such  objects  as  will  be  most 
beneficial  to  my  fellow-creatures,  and  at  the  same  time 
be  most  likely  to  afford  me  a  competence  when  my  labors 
shall  fail.  Taking  this  view  of  the  subject,  you  will  not 
think  it  surprising  that  I  should  decline  accepting  an 
8* 


90  CASTLETOX    PROFESSORSHIP. 

office,   the  emolument  of  which  would  be  less  than  what 
I  derive  from  my  practice. 

"  I  am,  sir,  with  sentiments  of  great  respect  and  esteem, 
your  obedient,  humble  servant, 

"  Amos  Twitchell. 

"  JRev.  Francis  Brown,  President  of 
Dartmouth  College." 

In  1824,  on  the  resignation  by  Dr.  Gallup  of  his 
professorship  at  the  Vermont  Academy  of  Medicine, 
the  late  Dr.  Allen  consulted  Dr.  Twitchell  about 
accepting  that  office.  He  did  so  simply  as  an  indi- 
vidual, and  I  mention  the  fact  merely  to  show  the 
reputation  of  Dr.  Twitchell.  I  am  not  aware  that 
any  formal  proposition  was  made  to  him  on  the 
subject.  In  April,  1826,  he  received  a  private  letter, 
informing  him,  that,  if  he  would  consent  to  accept 
of  the  office,  he  would  be  appointed  Professor  of 
the  Theory  and  Practice  of  Medicine,  Medical  Juris- 
prudence, and  Clinical  Practice,  at  Castleton.  Dr. 
Twitchell  seems  to  have  felt  as  on  the  previous  occa- 
sion, and  to  have  answered  much  in  the  same  terms. 
He  proceeds  thus  :  — 

"  My  professional  business  now  is  worth  more  than 
three  thousand  dollars  a  year,  and  I  am  so  situated  that 
the  probability  is  that  it  will  not  diminish,  if  my  health 
remains  good.  But,  sir,  if  I  should  leave  my  business 
two  or  three  months  in  a  year,  it  would  go  into  other 
hands  ;  it  would  be  thought  an  object  for  a  man  of  talents 
to  endeavor  to  divide  it  with  me,  and  he  would  most 
assuredly  be  able  to  accomplish  it.  These  considerations 
induced  me  to  decline  a  Professorship  in  the  Medical  In- 
stitution at  Dartmouth  College,  to  which  I  was  appointed 


PROFESSORSHIP   AT    BOWDOIN.  91 

by  the  corporation  a  few  years  since.  Had  you  found 
that  you  could  give  your  professor  twelve  or  fifteen  hun- 
dred dollars  per  year,  then  no  person  qualified  for  the 
office  would  hesitate  to  accept  of  the  appointment.  .  .  . 
Taking  this  view  of  the  subject,  you  will  not  think  me 
unreasonable  in  saying  that  I  should  feel  unwilling  to 
undertake  to  discharge  the  duties  of  the  professorship, 
unless  I  can  be  assured  of  at  least  twelve  hundred  dol- 
lars per  year. 

"  I  am,  sir,  with  respectful  consideration,  your  very 
humble  servant,  "Amos  Twitchele. 

"  Hon.  Chauncy  Langdon." 

In  June  of  the  same  year,  he  was  invited  to  be  the 
successor  of  his  able  and  beloved  master,  Dr.  Nathan 
Smith,  at  Brunswick,  Me.  He  received  a  letter 
from  Professor  Cleveland,  informing  him  that  Dr. 
Smith  was  about  to  retire.  To  this  letter  the  follow- 
ing reply  was  given  :  — 

"Keene,  July  28,  1826. 

"  Dear  Sir,  —  Sickness  has  hitherto  prevented  me  from 
answering  your  very  polite  letter  of  the  17th  ult.  I  have 
yet  an  affection  of  the  lungs,  which  renders  it  doubtful 
whether  I  shall  be  able  to  attend  to  much  business  at  pre- 
sent, if  ever.  Thus  circumstanced,  you  will  readily  per- 
ceive the  impropriety  of  my  accepting  of  a  professorship  in 
your  institution.  Was  my  health  firm,  it  would  be  folly 
in  me  to  relinquish  a  practice  worth  between  three  and 
four  thousand  dollars  a  year  in  a  pleasant  part  of  the 
country,  unless  I  could  be  as  pleasantly  situated  else- 
where. I  should  anticipate  much  pleasure  in  being 
connected  with  a  literary  institution,  would  my  health 
warrant  an  engagement  of  the  kind,  provided  I  could 
have  a  salary  that  would  remunerate  me  for  giving  up  a 


92  INVITED    TO    RESIDE    AT    BOSTON. 

lucrative  practice ;  but,  as  my  situation  now  is,  I  must 
renounce  any  idea  of  the  kind. 

"  Accept,  sir,  the  assurance  of  my  respect  and  esteem. 

"  Amos  Twitchell. 

"  Parker  Cleveland,  Esq." 

Finally,  in  1827,  he  was  requested  to  accept  of 
the  office  of  Professor  of  Surgery  and  Midwifery  in 
the  University  of  Vermont.  These  offers,  made  by 
so  many  literary  institutions,  prove  that  his  fame  was 
widely  spread.  There  were  likewise  many  efforts 
made  at  various  times  by  individuals  to  induce  him 
to  leave  Keene,  and  to  settle  in  a  large  city,  where  a 
wider  field  for  the  display  of  his  talents  might  have 
been  afforded.  It  will  be  perceived  by  the  following 
extract  from  a  letter,  that  some  wished  him  to  take 
up  his  residence  at  Boston.  He  did  at  times  think 
seriously  of  so  doing ;  but  the  dread  of  leaving  a 
certainty,  such  as  he  had  at  Keene,  for  an  uncer- 
tainty in  a  large  city,  probably  prevented  him. 

"  Boston,  oth  January,  1821. 
"  Dear  Sir,  —  It  was  my  intention,  before  I  left  Keene, 
further  to  converse  with  you  respecting  your  fixing  your 
residence  in  this  town ;  but  the  bustle  and  confusion  of  two 
or  three  of  the  last  days  prevented.  In  urging  you  to  this 
measure,  if  I  know  myself,  I  am  governed  by  friendly  mo- 
tives. I  have  advised  with  your  acquaintance,  and  others 
who  are  acquainted  with  your  reputation,  and  they  enter- 
tain but  one  opinion  on  the  subject,  and  that  altogether 
favorable  to  your  coming.  All  the  gentlemen  of  your 
profession,  save  two  of  high  standing,  would  be  delighted 
to  see  you  in  practice  here.  I  have  conversed  with 
Drs. ,  , , :  they  express  their  warmest 


TREPANNING    OF    THE    TIBIA.  93 

wishes  in  your  behalf.  If  you  will  take  a  view  of  the 
whole  ground,  you  find  that  not  one  argument  can  be 
brought  in  favor  of  your  remaining  in  that  cold,  inhospi- 
table clime."  .... 

In  1840  he  performed  an  operation,  from  which 
he  derived  an  enviable  reputation  among  his  friends, 
and  not  a  few  medical  practitioners.  The  follow- 
ing account  of  that  case  I  have  obtained  from  Dr. 
Hosmer  of  Watertown,  who,  in  a  letter  to  me, 
writes  thus :  — 


"  E W ,  of  N ,  Mass.  at  the  date  of  the 

operation,  February,  1840,  was  thirty  years  of  age,  and  of 
a  scrofulous  habit.  He  had  suffered  almost  constant  and 
often  very  severe  pain,  just  below  the  knee,  for  eighteen 
years.  It  was  always  referred  to  the  same  place,  which 
presented  scarcely  any  change  in  the  external  appearance, 
save  that,  under  a  very  careful  examination,  a  slight  en- 
largement could  be  observed.  He  had  been  under  the 
care  of  the  most  eminent  of  the  faculty  without  any  per- 
manent relief.  At  the  time  above  named,  while  on  a  visit 
to  his  (Dr.  Twitchell's)  house,  I  described  the  case ;  and, 
to  illustrate  his  character  for  rapidity  of  diagnosis,  and  as 
evidence  of  his  professional  decision  and  readiness  to  pro- 
ceed at  once  to  a  formidable  operation  in  a  case  extremely 
rare,  I  will  state  his  reply.  *  There  is  matter  in  the 
bone.'  'Why  do  you  think  so?'  'I  have  seen  just 
two  cases.'  ■  How  did  you  ascertain  their  character  : ' 
'  I  amputated  and  examined  the  bones.'  *    On  my  return 

*  I  have  heard  from  good  authority  that  a  deaf  and  dumb  man 
was  at  the  last  operation  ;  and  that,  when  he  saw  the  pus  running 
from  the  bone,  he  gave  a  significant  glance  at  the  doctor,  and  imi- 


94  BRODIE    ANTICIPATED    HIM. 

home,  I  stated  to  the  patient  Dr.  Twitchell's  opinion  ;  and 
the  next  day  he  was  on  his  journey  to  Keene,  where,  on 
the  day  after  his  arrival,  Dr.  Twitchell  trephined  the 
bone,  and  discharged  one  and  a  half  ounces  of  pus.  The 
wound  closed  in  a  few  weeks,  since  which  time  the  patient 
has  been  perfectly  well."  * 

Dr.  Twitchell  thought  this  operation  of  trepanning 
the  bone  was  his  own,  and  that  no  one  had  preceded 
him,  although  it  is  certain  that  he  never  publicly  pro- 
claimed this  opinion.  Most  of  his  neighbors  and 
friends,  however,  believed  it  was  his.  Eminent  sur- 
geons regarded  it  as  such.  I  do  not  think  that  he 
ever  saw  the  paper  published  by  Sir  Benjamin 
Brodie  f  in  1332 ;  that  is,  eight  years  before  Dr. 
Twitchell  performed  the  operation.  In  this  interest- 
ing paper,  that  eminent  surgeon  gives  details  of  his 
proceedings  in  three  cases.  In  the  first,  amputation 
was  performed.  In  the  second,  after  partial  relief 
had  been  obtained  by  cutting  down  merely  on  the 
bone,  trepanning  was  proposed,  and  performed  with 
entire  success.  Subsequently  another  case  hap- 
pened, in  which  trepanning  was  performed  imrae- 

tated  with  his  hand  the  motions  necessary  in  using  a  gimlet  or 
awl ;  indicating  that  he  perceived  the  leg  might  have  been  saved, 
had  the  bone  been  perforated. 

*  Since  writing  the  above,  I  have  seen  a  full  account  of  the 
case  as  described  by  the  patient  himself.  By  it,  it  appears  that  he 
had  consulted  the  most  eminent  surgeons  in  Massachusetts,  some 
of  whom  had  treated  him  for  months.  No  one,  however,  had  dis- 
played the  diagnostic  subtlety  evinced  by  Twitchell. 

t  Med.-Chirurg.  Trans,  vol.  xvii. ;  1832  ;  "  Chronic  Abscess  of 
the  Tibia."  James  Deane,  M.D.  of  Greenfield,  Mass.  has  lately 
published  some  interesting  cases  of  the  same  kind  :  Boston  Medi- 
cal and  Surgical  Journal,  1850. 


EXTENSIVE    MEDICAL    PRACTICE.  9-J 

diately,  and  with  a  like  result.  These  cases,  as  I 
have  stated,  were  published  in  1832,  in  a  work  which 
much  too  rarely  found  its  way,  at  that  time,  to  this 
country.  I  believe  that  to  Twitchell's  sagacity  his 
patient  owes  his  restoration  to  health  ;  and,  although 
I  cannot  prove  to  indifferent  persons  that  the  cases  by 
Brodie  were  not  seen  by  him,  I  have  reasons  which 
satisfy  me  that  such  was  the  fact. 

Dr.  Twitchell's  medical  and  surgical  practice, 
during  the  last  twenty  years  of  his  life,  was  very  ex- 
tensive. Before  his  marriage,  as  we  have  already 
seen,  he  used  to  ride  on  horseback  thirty  or  forty 
miles  a  day.  In  later  life  he  always  drove  a  sulky ; 
and  his  custom  was,  when  called  to  a  distant  spot,  to 
tell  the  physician  he  was  going  to  meet  in  council, 
that  he  would  be  at  the  appointed  spot  by  a  certain 
hour ;  that  he  should  wait  for  him,  if  necessary,  fif- 
teen minutes,  but  he  wanted  no  one  to  wait  even  five 
for  himself.  Rising  before  daybreak,  he  immediately 
took  breakfast,  and  was  usually  far  on  his  way 
before  the  dawn.  He  allowed  himself  time  enough 
to  go  the  distance  required,  at  the  rate  of  six  miles 
an  hour.  He,  however,  always  travelled  faster  than 
that,  and  had  a  series  of  post  horses  at  the  various 
country  inns.  In  the  cold  morning  hour,  the  drowsy 
ostler  of  some  of  them  would  be  awakened  by 
Twitchell  with  orders  for  a  change  of  horses.  At 
times  he  was  stopped  on  his  route  by  some  patient. 
If  in  a  great  hurry,  he  would  prescribe  without 
getting  from  his  chaise.  In  the  winter  time  these  ex- 
cursions were  very  severe ;  and  not  a  few  times  he 
was  overtaken,  when  many  miles  from  home,  by  one 


96  LONG    DRIVES    AND    DANGERS. 

of  those  furious  storms  of   snow  that  sweep  over 
New  Hampshire.     He  was  perhaps  wholly  unable 
to  proceed  ;  the  roads  being  all  blocked  up,  and  the 
storm  driving  pitilessly  upon  his  wearied  horse.     On 
one  or  two  occasions,  he  nearly  gave  up  all  hopes  of 
getting  safely  home,  and  thought  his  last  hour  was 
come.     Chilled  through  by  the  severity  of  the  cold, 
and  covered  with  snow,  there  seemed  no  escape  for 
him.     However,  his  own  brave  heart  and  practical 
common  sense  sustained  him,  and  he  always  con- 
trived to  overcome  the  difficulty.     Returning  home, 
he  would  throw  himself  at  full  length  upon  the  sofa. 
"  Tired     nature's    sweet    restorer,    gentle    sleep," 
would  come  over  him,  and  in  a  few  hours  he  would 
be   again    able  to   repair   to  his  accustomed  place 
about  the  village-tavern  to  discuss  temperance,  crack 
jokes,  or  talk  about  his  profession,  &c.     On  the  next 
day,  he  was  all  ready  for  another  and  perhaps  simi- 
lar trip  to  the  mountains.     Such  has  been  his  course 
from  year  to  year  for  more  than  a  third  of  a  cen- 
tury.    Towards  the  latter  part  of  his  life,  his  wide 
practice  and  these  long  rides  became  so  oppressive 
to  him  by  their  very  number,  that  he  was  obliged  to 
refuse  some  of  them.     Accordingly,  he  prepared  the 
following  circular,  which  is  found    among   his  pa- 
pers: — 

"  I  regret  to  say,  that  it  is  not  in  my  power  to  attend 
to  half  the  calls  which  I  have.  I  do  all  that  I  can  ;  and  I 
endeavor,  as  far  as  I  am  able,  to  do  my  duty,  by  attending 
those  cases  which  have  a  superior  claim  to  my  services. 
It  would  be  gratifying  to  my  feelings,  could  I  comply  with 
the  wishes  of  all ;  but  that  is  impossible. 


CIRCULAR    TO    PATIENTS.  97 

"  I  consider  that  capital  surgical  operations  have  the  first 
claim,  as  there  is  no  other  operator  in  this  vicinity  ;  after 
which,  my  immediate  friends  and  neighbors  ;  and  then  I 
enlarge  the  circle,  according  to  the  urgency  and  import- 
ance of  the  cases :  and  in  this  way  do  all  I  can." 

After  he  had  arisen  to  fame  and  to  an  honorable 
independence,  he  did  not  forget  the  trials  of  a  young 
man  when  just  commencing  medical  practice.  The 
recipients  of  his  bounty  were  not  a  few,  and  the 
depth  of  their  gratitude  their  own  hearts  can  alone 
tell.  The  following  letter  to  one  of  them,  under 
date  of  Nov.  20,  1841,  I  transcribe :  — 

"Yours  of  the  14th  instant  was  received  night  before 
last.  You  say  you  have  not  as  yet  taken  a  ticket  for 
dissection,  and  shall  wait  till  you  hear  from  me,  as  you 
have  not  much  time,  and  shall  be  short  of  funds.  I  think 
it  is  all-important  you  should  dissect  as  much  as  your 
health  will  admit,  and  should  advise  you  by  all  means  to 
take  your  tickets  for  that  purpose.  Now  is  your  time 
to  lay  a  sure  foundation  for  future  eminence.  Your  op- 
portunities now  are  superior  to  any  which  I  had  the  means 
of  enjoying  when  I  was  a  student;  and  I  have  no  doubt 
you  will,  by  your  industry  and  perseverance,  make  the 
most  of  them.  It  certainly  will  be  a  great  gratification  to 
me  if  I  should  live  to  see  you  taking  a  high  stand  in  the 
profession,  and  should  consider  myself  remunerated  for  all 
I  have  done  or  shall  do  for  you.  I  know  that  you  will  not 
spend  money  for  nought,  and  I  shall  be  willing  to  furnish 
all  necessary  funds.  I  wish  you  to  write  me  frequently 
how  you  get  along.  If  you  learn  of  any  improved  surgical 
instrument,  or  any  valuable  medical  or  surgical  treatise, 
which  will  be  very  useful,  I  wish  you  to  purchase  them, 
9 


98  TEMPERANCE    ADVOCATE. 

and  I  will  forward  you  a  draft  or  cash  for  what  you  may 
want  at  the  close  of  the  term  ;  a  short  time  before  which, 
I  wish  you  to  write  the  exact  amount  that  will  be  want- 
ing. —  Yours  arlectionately, 

"A.    TWITCHELL." 

Dr.  Twitchell  seems  to  have  early  learned  the  ad- 
vantages of  temperance  in  the  use  of  alcoholic  and 
intoxicating  drinks,  and  most  steadily  did  he  adhere 
to  the  opinions  instilled  into  him  by  his  parents.     He 
was  at  times  quite  severe  in  his  denunciations  of  the 
habitual  drunkard,  and  was  not  afraid  to  speak  to 
any  one  on  the  subject.     In  fact,  some  of  those  who 
were  disposed  to  drink  regarded  it  as  his  favorite 
"  hobby,"  and  thought  he  was  officious  in  proffering 
advice.    He  often  alluded  to  it  whenever  an  opportu- 
tunity  offered.     The  following  is  an  amusing  illustra- 
tion of  his  method  of  treating  the  subject:   It  was  a 
very  cold  winter's  day,  and  Twitchell  had  been  riding 
far  and  long,  and  had  stopped  to  rest  and  warm  him- 
self at  a  country  inn.     While  waiting,  and  enjoying 
the  genial  glow  of  the  roaring  fire,  two  young  men 
entered  the  bar-room,  and  in  boisterous  tones  asked 
for  liquor.     Decanters  were  placed  before  them,  and 
their  potations  were  by  no  means  small.     After  look- 
ing at  them  a  short  time,   Twitchell,  in  a  similar 
manner,  went  to  the  bar-keeper,  and  asked  for  a  glass 
of  water.     The  water-jug  and  tumbler  were  given 
to  him,  and  he  drank  as  much  as  he  wished.     He 
then  took  out  his  purse,  and  laid  a  ninepence  upon 
the   counter.      The  attendant   stared,  —  the  youths 
smiled  at  the  "  greenhorn."      "  We  don't  ask  any 
thing  for  water,"  said  the  waiter,  with  a  suppressed 


ANECDOTE.  99 

titter.  "  Oh  !  "  said  Twitchell,  "  I  can  better  afford 
to  pay  you  ninepence  for  a  glass  of  water  and  the 
benefits  of  this  warm  fire,  than  these  young  men  can 
afford  to  pay  half  that  sum  for  liquor."  As  a  general 
rule,  he  held  no  long  arguments.  He  desired  to 
produce  the  requisite  effect  by  a  style  more  simple. 
In  case  of  poor  men,  he  tried  to  overcome  the  habit 
by  keeping  the  individuals  at  work.  One  poor  fellow 
came  to  split  his  wood,  when  so  full  of  tremor  from 
the  effects  of  recent  debauch  that  he  could  hardly 
stand.  Whilst  there  was  a  will  to  resist  the  tempter, 
he  was  gentle  as  a  woman  with  the  sinner ;  but,  if 
he  perceived  a  dogged  determination  to  continue  the 
evil  course,  the  vials  of  his  wrath  would  be  opened 
upon  the  unhappy  victim  of  appetite.  He  was 
probably  more  severe  on  these  persons,  from  the  fact 
that  he  was  so  constituted  as  to  be  able  to  control 
entirely  the  indulgence  of  his  own  appetite  for  food 
and  drink. 

His  dislike  for  tobacco-chewing  and  smoking  was 
equally  great.  He  had  a  theory  upon  that  subject, 
which  he  undoubtedly  carried  too  far,  but  which  is 
true  in  many  instances.  He  told  me  that  he  believed 
that  tobacco  killed  more  persons  than  intemperance. 
The  following  anecdote  is  related  of  him  :  A  farmer 
who  lived  some  twenty  miles  from  Keene,  and  who 
had  often  supplied  the  doctor  with  grain,  was  met 
by  Dr.  Twitchell  one  day  when  he  was  looking 
miserably  out  of  health.  On  being  questioned  as 
to  his  health,  he  replied,  with  a  very  serious  face, 
"  Almost  gone,  doctor  !  I  shall  never  bring  you  any 
more  corn.     The  physicians  have  all  given  me  up, 


100  TEMPERANCE  DELEGATE. 

and  tell  me  I  am  dying  of  consumption."  "  Ah  ! 
indeed,"  replied  our  friend,  in  his  lively  tones ;  "  I 
am  quite  sorry  I  shall  have  no  more  of  your  corn ; 
but  possibly,  after  all,  it  may  not  be  so  bad  as  you 
think  :  I  may  be  able  to  cure  you."  "  It  is  too  late," 
solemnly  replied  the  man ;  "  I  must  put  my  house 
in  order,  and  prepare  to  die.  So  all  tell  me,  and  I 
believe  them."  "But,"  said  Dr.  Twitchell,  "I  will 
make  a  bargain  with  you.  You  shall  agree  to  fol- 
low my  prescriptions  three  months :  if  you  recover 
your  health,  you  shall  pay  me  fifty  bushels  of  corn  ; 
and,  if  you  fail  to  follow  the  prescription,  you  are 
likewise  to  pay  me  fifty  bushels  of  corn :  but,  if  you 
follow  the  prescription  without  getting  well,  I  will 
pay  to  you  or  your  heirs  the  value  of  fifty  bushels 
of  corn,  without  receiving  any  compensation."  To 
this,  after  some  demur  on  his  part,  the  invalid 
agreed ;  and  was  immediately  directed  to  take  the 
quid  from  his  mouth,  to  dash  it  to  the  ground,  and 
never  to  touch  tobacco  in  any  form  again.  Six 
months  or  more  passed  away,  when  Dr.  Twitchell 
met  the  man,  apparently  in  perfect  health,  and 
claimed  the  corn.  The  farmer  declined  paying  it, 
saying  that  his  wife  thought  it  more  than  his  life  was 
worth  !  He,  however,  finally  compromised  the  mat- 
ter, by  leaving  three  or  four  bushels  of  corn  and  a 
bushel  of  white  beans  !      (See  Appendix  L.) 

In  1832,  Dr.  Twitchell  made  a  visit  to  Philadel- 
phia, as  a  delegate  from  the  New  Hampshire  State 
Medical  Society  to  a  convention  of  the  friends  of 
temperance  in  America.  While  there,  the  following 
anecdote   occurred  :    Twitchell  met   many  old  ac- 


ANECDOTE.  101 

quaintances,  and  made  several  new  ones.  With  one 
or  another  of  these  he  was  constantly  conversing, 
when  at  the  hotel ;  and  invariably  his  bright,  eager, 
and  jovial  mode  of  talking  would  draw  a  crowd 
around  the  party.  This  was  just  the  element  he 
liked  ;  and  usually  he  would  engage  in  long  discus- 
sions on  any  subject  that  happened  to  be  brought 
up,  or  perhaps  he  would  give  an  extemporaneous 
lecture  on  the  pathological  effects  of  alcohol  or 
tobacco.  One  day  he  had  been  describing,  in  his 
exquisitely  graphic  manner,  the  gradual  inroads 
made  by  tobacco  upon  the  human  system.  He  first 
displayed  the  gentlest  effects  of  this  "  celestial  drug." 
The  slightest  nervousness  or  most  trivial  pain  was 
perhaps  all  that  the  sufferer  noticed.  Then  came 
the  horrid  dreams  and  nightmares  dire,  with  indiges- 
tion and  all  its  miserable  train.  After  talking  thus 
for  some  time,  he  proceeded  still  farther,  and  had 
just  touched  upon  the  point  where,  according  to  Dr. 
Twitchell's  theory,  the  victim  of  appetite  will  see 
death  staring  at  him.  All  his  audience  were  listen- 
ing with  deep  interest,  and  silence  reigned  in  the 
room,  when  suddenly  one  gentleman  dropped  sense- 
less. He  had  listened  with  great  attention,  and  was 
horror-struck  at  fancying  that  he  had  arrived  at  the 
fatal  point  in  his  journey  as  a  tobacco-chewer.  He, 
however,  soon  recovered  from  his  swoon,  and  from 
that  moment  forswore  the  use  of  the  article  in  any 
shape. 

Dr.  Twitchell  was  not  unfrequently  invited  to 
deliver  temperance  addresses.  He  sometimes  did 
so,  although  he  was  not  so  successful  in  a  lecture  or 

9* 


102  TEMPERANCE  DOCUMENT. 

continued  speech  as  he  was  in  simple  conversation 
on  the  great  topic  to  which  he  devoted  so  much  of 
his  life.  It  is  well  known  that  he  gained  for  himself 
many  enemies  by  his  bold  denunciations  of  those 
who  sold  intoxicating  liquor.  It  has  been  intimated 
to  me,  that  the  venders  of  the  poison  intended,  by  a 
deeply  contrived  plot,  to  utterly  ruin,  or  at  least 
injure,  him  in  his  pecuniary  resources ;  and  that  a 
trivial  occurrence,  though  very  honorable  on  the  part 
of  one  of  his  enemies,  alone  prevented  the  catastro- 
phe. Twitchell  was  not  one  to  think  of  consequences 
to  himself,  when  a  principle  was  involved.  Would 
that  we  had  more  men  like  him  in  this  respect ! 

The  following  documents  I  find  among  his  pa- 
pers :  — 

11  Your  plan  meets  my  views,  and  shall  have  my  cor- 
dial approbation  and  support.  For  thirty  years  have  I 
unceasingly  labored  to  convince  my  friends,  that  ardent 
spirit  is  not  only  an  useless  but  a  dangerous  beverage ; 
and  for  more  than  twenty-five  years  have  I  professionally 
and  publicly  borne  testimony  to  its  pernicious  and 
poisonous  effects  upon  the  human  constitution.  Never 
have  I  used  it  myself,  or  offered  or  given  it  to  others,  ex- 
cept as  a  medicine  in  sickness,  and  as  such  but  seldom. 
The  exertions  which  I  had  for  so  long  a  time  used  induced 
the  friends  of  temperance,  when  societies  were  formed  in 
this  State,  to  elect  me  president  of  the  town  and  the  county, 
and  subsequently  of  the  State  society.  The  two  former 
offices  I  still  hold ;  but,  at  the  last  meeting  of  our  State 
society,  I  was  not  present,  and  have  not  seen  any  official 
account  of  their  proceedings,  but  have  understood  that 
Edmund  Parker,  Esq.  of  Amherst,  was  elected  presi- 
dent." 


POLITICS.  103 

"Keene,  January  3,  1832. 

"  Dear  Sir,  —  Your  letter  bearing  date  December  1st, 
1831,  directed  to  Salisbury,  N.H.  enclosing  a  circular  of 
the  New  York  Temperance  Society,  has  but  just  reached 
me.  The  cause  in  which  you  are  engaged  has  long  been 
the  object  of  my  most  strenuous  exertions.  The  plan 
which  you  propose     [Sentence  unfinished.] 

"  I  should  consider  it  an  honor  to  have  my  name  attached 
to  the  circular,  as  you  propose ;  but,  although  there  is  no 
date  to  the  one  you  enclosed,  yet  I  suppose  it  would  be 
desirable  that  the  names  of  the  present  officers  should 
be  attached  ;  but  of  that  you  can  best  judge.  You  have 
full  liberty  to  use  my  name  if  you  think  best :  if  you  do 
not  obtain  the  name  of  the  president  for  the  time  being, 
and  you  date  your  circular  the  present  year,  I  would  sug- 
gest the  propriety,  if  you  use  my  name,  to  attach  it  as 
president  of  the  Cheshire  County  Temperance  Society,  and 
late  president  of  the  New  Hampshire  State  Temperance 
Society.  Our  county  society  will  meet  in  a  few  days.  I 
shall  read  your  circular  to  them,  and  have  no  doubt  but 
that  they  will  highly  approve  of  the  plan,  and  will  order 
a  large  number  for  immediate  distribution. 

"  Our  State  society  will  not  hold  a  meeting  again  till 
next  June,  unless  there  is  one  specially  called :  of  course 
your  plan  cannot  be  laid  before  them  till  that  time,  pre- 
vious to  which  I  think  much  may  be  done  by  our  town 
and  county  societies.  If  it  is  your  desire,  I  will  forward 
your  letter  and  circular  to ."  .  .  . 

In  politics,  Dr.  Twitchell  was  in  early  life  a  federal- 
ist, and  afterwards  a  staunch  whig.  He  followed, 
like  many  others,  the  rule  of  the  party  leaders ;  and 
yielded,  as  it  seemed  to  some  of  his  friends,  a  blind 
deference  to  the  opinions  of  the  great  men  of  that 


104  ASYLUM    FOR    INSANE. 

party.  He  was,  however,  what  might  be  called  a 
reasonable  conservative,  —  not  a  zealot  in  whiggism  ; 
but  at  the  same  time  he  had  an  almost  holy  horror  of 
any  taint  of  democracy,  as  he  saw  it  in  New  Hamp- 
shire. Daniel  Webster  was  his  file  leader,  his 
Magnus  Apollo  ;  and  he  listened  to  his  voice  as  to 
that  of  a  god. 

Dr.  Twitchell  was  very  much  interested  in  the 
establishment  of  the  Asylum  for  the  Insane  in  New 
Hampshire,  and  continued  to  be  so  for  some  months, 
until  he  thought  that  politics,  which  in  this  country 
creep  in  everywhere,  were  associated  with  the 
management  of  the  institution ;  then  he  retired  in 
disgust. 

In  1845-6,  the  germs  of  the  present  American 
Medical  Association  were  planted  in  the  State  of 
New  York.  Chiefly  to  the  labors  of  Professor  N.  S. 
Davis,  now  of  Chicago,  then  resident  at  Binghamton, 
New  York,  does  the  medical  profession  owe  the 
scheme  of  this  association,  which  has  already  done 
very  much  towards  raising  the  standard  of  the  medical 
profession  in  the  United  States.  It  has  done  this,  not 
so  much  by  the  enactment  of  specific  laws  and  the 
adoption  of  certain  votes  ;  for  upon  some  of  these  lat- 
ter measures  there  is  a  great  discrepancy  of  opinion. 
But  for  the  stimulus  it  gives  to  individual  action,  in 
consequence  of  the  congregating  together  of  so  many 
of  the  really  zealous  and  learned  of  the  profession  ; 
for  the  kindly  sympathies  its  re-unions  excite  in  the 
bosoms  of  all ;  for  the  liberal  opinions  which  the 
members  gain  by  meeting  and  comparing  views,  as 
diverse   as  those  of  a  profession  extended  over  so 


AMERICAN    MEDICAL    ASSOCIATION.  105 

large  an  extent  of  country  must  necessarily  be  ; 
above  all,  for  the  noble  esprit  de  corps  which  it  raises 
amongst  us,  —  for  these  benefits,  and  others  inci- 
dental thereto,  this  association  and  its  founders 
deserve  high  praise. 

Dr.  Twitchell  early  took  an  active  interest  in  it. 
He  was  not,  however,  present  in  New  York  in  1846. 
At  Philadelphia,  he  appeared  as  delegate  from  the 
New  Hampshire  Medical  Society.  He  was  a  mem- 
ber of  the  National  Committee  that  year.  He 
enjoyed  very  much  the  society  of  the  magnates  of 
our  profession,  about  whom  he  had  heard  so  long, 
some  of  whom,  however,  he  had  never  seen.  In 
1848,  his  nephew,  Dr.  George  Twitchell,  attended  in 
his  stead  ;  for  it  seems  to  have  been  his  purpose  that 
one  or  the  other  should  always  be  present,  as  had 
been  the  case  for  years  with  regard  to  the  New 
Hampshire  Medical  Society.  In  truth,  he  believed 
that  actual  bodily  presence  is  a  more  manifest  proof 
of  the  interest  that  one  takes  in  any  association  than 
any  amount  of  writing  or  talking  upon  the  subject. 
"We  all  remember  him  at  the  meeting  in  Boston,  at 
which  time  he  presided  over  the  National  Business 
Committee,  which  was  composed  of  the  elite  of  the 
profession.  In  the  general  meetings  of  the  asso- 
ciation he  never  spoke,  save  on  business  connected 
with  this  committee.  He  was  one  of  those  men  who 
talk  little  in  public,  but  much  in  the  private  circle  ; 
so  that  his  influence,  perhaps  unseen,  was  all-power- 
ful. I  have  learned  that  he  was  particularly  de- 
lighted at  this  meeting  with  the  attentions  paid  to 
him  by  the  younger  members  of  the  profession,  whose 


106  DELEGATE    TO    PHILADELPHIA. 

spontaneous  outpourings  of  respect  he  received  with 
a  modest  self-complacency,  which  was  at  times 
quite  naive  in  its  manifestations.  He  possessed  the 
attribute  common  to  every  commanding  intellect,  — 
a  consciousness  of  power,  which  demands  no  ex- 
ternal tributes  of  respect,  nor  are  they  necessary 
to  its  happiness ;  but,  if  given,  they  are  accepted 
with  the  simplicity  and  delight  a  child  may  mani- 
fest when  receiving  the  caresses  of  its  friends. 
In  Boston,  as  in  Philadelphia,  he  met  with  most 
of  those  who,  in  different  quarters  of  the  Union, 
had  gradually  like  himself  been  rising  to  an 
honorable  fame :  A.  H.  Stevens,  the  Nestor  of  New 
York  Surgery ;  the  distinguished  President  of  the 
Association,  J.  C.  Warren,  of  Boston;  his  early 
friend,  Shattuck,  whose  heart  had  been  well  knit  to 
his,  ever  since  they  bathed  while  youths  in  the 
waters  of  the  Sowhegan  ;  Dr.  Knight,  of  Connecti- 
cut, who,  though  still  in  the  prime  of  life,  reminds  us, 
by  his  elegant  and  accomplished  mind  and  manner, 
of  the  perfect  gentleman  "of  the  old  school ; "  a 
host  of  worthies  from  Philadelphia,  young  and  old, 
among  whom  rise  pre-eminent  the  two  Jacksons, — 
the  veteran  and  well-beloved  professor,  and  he,  of 
sterling  worth,  from  Northumberland  ;  his  old  pupil, 
Bond ;  and,  drawn  towards  him  in  a  particular  man- 
ner by  the  kindred  pursuit  of  surgery,  the  young, 
earnest,  and  rising  Mutter.  From  Maryland  ap- 
peared to  greet  him  the  honored  son  of  an  honored 
father,  Nathan  R.  Smith  ;  and,  finally,  from  the  Far 
West,  his  long-tried  friend,  Professor  Mussey,  of 
Cincinnati.     In  addition  to  these,  I  may,  not  invi- 


AMERICAN   MEDICAL   ASSOCIATION.  107 

diously  I  hope,  allude  to  Parker  of  New  York,  and 
Johnson  of  Missouri,  as  two  of  the  younger  scions 
of  surgery  who  were  delighted  to  do  him  reverence. 
How  much  he  enjoyed  the  society  of  these  and  of 
many  others  none  now  can  tell ;  but  it  is  certain  that 
he  returned  to  the  Granite  Hills  refreshed  and  invigo- 
rated for  new  labor  ;  and  one  of  the  severest  trials  of 
his  latter  days,  to  which  he  could  scarcely  allude 
without  tears,  was  the  fact  that  he  could  not  meet 
again  the  hosts  of  our  honorable  calling  at  the  Queen 
City  of  the  West,  where  Drake  and  Caldwell,  Mil- 
ler and  Gross,  Johnson  and  Mussey,  would  have 
received  him  with  open  arms  upon  their  own  ground. 
Fate  had  decided  otherwise.  His  failing  health 
warned  him  not  to  try  such  a  journey  ;  and,  in  a  few 
weeks  subsequent  to  the  meeting  in  Cincinnati,  he 
was  no  more. 


108 


CHAPTER   VII. 


FROM    1815    TO    1850.  JET.   34—69. 


Social  Qualities.  —  Jokes  at  the  Hotel.  —  Repartee  to  a  Law- 
yer ;  to  a  Friend.  —  Intercourse  -with  Medical  Associates.  — 
Autocrat  of  Surgery.  —  His  Faith,  in  the  Profession.  —  Inter- 
course with  Patients.  —  Roughness  at  First.  —  Exquisite  Ten- 
derness. —  Behavior  in  the  Chamber  of  Death.  —  Kindness  to 
the  Poor. — Anecdote.  —  Practical  Tact. — Violence  occasion- 
ally. —  Allegro  and  Penseroso.  —  Delights  of  being  Bled.  — 
Neuralgia  Case.  —  Hatred  of  Quackery.  —  Open  Confidence  in 
Patients.  — "Willing  to  confess  Error.  —  His  Operations ;  Anxi- 
ety to  act  rightly  about  them ;  Calmness  -while  performing 
them.  —  Private  Hospital.  —  Intercourse  -with  his  Family  : 
Children.  —  Domestic  Discipline.  —  Religious  Views. 

No  one  ever  enjoyed  better  than  Dr.  Twitchell  the 
society  of  human  beings.  He  found  a  certain  degree 
of  pleasure  in  the  contact  of  any  man,  however  hum- 
ble or  ignorant.  This  tendency,  combined  with  his 
jovial  spirit,  led  him,  as  we  have  seen,  frequently  to 
the  village  tavern.  In  former  days,  when  an  arrival 
of  the  coach  was  an  important  event  in  the  history 
of  each  day,  and  in  later  times,  since  the  car's 
whistle  has  superseded  the  coachman's  horn,  he  was 
always  present,  if  professional  business  would  allow, 
at  the  time  of  the  arrival  of  passengers.  Cordially 
did  he  greet  old  well-known  friends ;  and  how  slily 


SOCIAL    QUALITIES.  109 

did  his  bright  gray  eye  shine  out  inquisitively  upon 
the  face  of  the  stranger  ? 

Whenever  a  knot  of  merry  laughers  was  seen  near 
the  main  hotel,  one  might  be  almost  certain  to  find 
Twitchell  among  them.  It  was  in  these  coteries 
that  he  preached  upon  intemperance  in  the  use  of 
wine  and  tobacco.  At  the  inn,  too,  he  would  tell 
his  jokes ;  and,  in  early  life,  it  is  said  that  he  often 
spent  half  the  night  at  whist,  after  having  passed  the 
day  in  riding  far  and  near.  Such  associations  might 
seem  likely  to  contaminate ;  but  this  was  not  the 
case  with  him.     His  amusements  were  innocent. 

His  powers  at  a  quiet  repartee  were  great.  I  have 
heard  the  following  anecdotes  : — 

Dr.  Twitchell,  in  the  early  part  of  his  residence  at 
Keene,  had  been  called  as  a  witness  in  a  case  of  mal- 
practice. As  was  usual  with  him,  he  gave  his  evi- 
dence coolly,  but  decidedly.  The  opposing  lawyer 
had,  at  a  cross-examination,  a  great  deal  of  the  pe- 
culiar skill  for  which  the  bar  of  New  Hampshire  has 
been  always  celebrated ;  and  on  this  occasion  he 
pressed  hard  upon  the  young  physician.  The  doc- 
tor, in  his  testimony,  had  stated  some  things  in 
reference  to  medical  cases  among  the  Indians,  and 
the  lawyer  thought  to  make  him  confess  ignorance 
upon  the  subject.  In  vain  did  the  advocate  ap- 
proach the  matter.  Twitchell  was  armed  at  all 
points  with  simple  truth.  Finally,  his  opponent  ab- 
ruptly asked,  "  Why,  how  can  you  know  about  this  ? 
Have  you  ever  been  among  the  Indians  ?  "  Twit- 
chell stopped  a  moment,  and  then,  looking  steadily 
at  the  advocate,  said  with  the  most  gentle  and  yet 
10 


110  ANECDOTE. 

culling  irony  in  his  manner,  "  I  have  sometimes  been 
with  half-civilized  persons  !  "  The  shock  was  electric ; 
the  whole  court  was  convulsed  with  laughter  at  the 
"  palpable  hit."  The  lawyer  was  taken  by  surprise, 
and  completely  silenced  so  far  as  cross-questioning 
further  in  that  case  was  concerned.  I  believe  very 
few  members  of  the  bar  ever  afterwards  wanted  to 
try  their  skill  at  making  Dr.  Twitchell  contradict 
himself.     He  was  quite  a  match  for  any  one. 

At  times  his  repartees  were  severe.  Some  years 
since,    two    noted   persons   were   at    Keene    at   the 

same  time,   namely,  Gov.   D ,  of ,   and   a 

celebrated  convict,  who  had  escaped  from  several 
places  of  confinement,  and  at  length  was  safely 
secured  in  the  stone  jail  at  Keene.  One  day,  a 
friend  met  Dr.  Twitchell,  and  said  jocosely,  "Well, 
doctor,  have  you  called  at  the  Cheshire  upon  Gov. 

D ?  "     "  Oh,  no  !  "  instantly  replied  Twitchell, 

"  I  have  not  yet  paid  my  respects  to  Hicks !  " 

An  eminent  jurist  informs  me,  that  Dr.  Twitchell 
was  not  generally  sought  for  as  a  witness  in  favor  of 
wills  made  during  the  last  illness  of  the  testator,  be- 
cause he  had  great  doubts  as  to  the  perfect  sanity  of 
a  person  when  near  death.  These  doubts  arose 
from  the  following  incident :  A  patient  was  supposed 
to  be  near  dying ;  but,  as  his  mind  seemed  perfect, 
his  will  was  made,  and  the  doctor  was  a  witness 
of  it.  The  man  did  not  die  ;  but,  on  his  recovery, 
he  had  not  the  least  recollection  of  ever  having 
attempted  to  make  a  will,  and  could  not  tell  any  of 
its  provisions !  This  incident,  of  course,  shook  his 
faith  in  all  wills  made  towards  the  end  of  life.    While 


INTERCOURSE    WITH    PHYSICIANS.  Ill 

appearing  as  a  medical  witness,  Dr.  Twitchell  was 
unusually  clear  and  precise,  and  avoided  as  much  as 
possible  merely  technical  terms,  so  that  the  court  and 
jury  always  bore  testimony  to  his  skill. 

In  his  intercourse  with  physicians,  he  was  a  man 
who  never  asked  for  a  consultation.  He  was  a  law 
unto  himself.  Doubtless  he  felt  himself  quite  equal 
to  any,  and  altogether  superior  to  most  physicians. 
Whenever  he  did  meet  his  professional  brethren,  he 
was  scrupulously  fair  and  courteous.  His  innate 
sense  of  justice  kept  him  true,  and  he  was  too  proud 
to  be  unjust  even  if  he  disliked  a  man.  Sometimes, 
when  dealing  with  a  pretender,  who  covered  his  igno- 
rance with  high-sounding  words,  he  would,  with 
perfect  Socratic  simplicity,  ask  what  he  meant  by 
some  peculiar  idiom  or  word,  knowing  all  the  while 
that  he  was  about  to  make  the  fool  prove  his  own 
folly.  He  was  a  most  thorough  hater  of  all  hypoc- 
risy in  medicine  as  in  religion  ;  and  his  powers  of 
vituperation  were  not  small,  when  he  came  closely  in 
contact  with  a  quack.  Rarely  has  any  one  appeared 
to  me  to  desire  more  to  avoid  even  the  semblance  of 
quackery.  If  a  physician  had  once  treated  him  im- 
properly, he  never  forgot  it.  The  remembrance 
would  at  times  peer  forth  ;  but  this  prejudice  seemed 
rarely  to  influence  his  reason,  and  he  always  treated 
such  a  man  impartially  unless  he  had  been  guilty  of 
some  moral  obliquity,  and  then  he  refused  to  meet 
him  by  the  bedside  of  the  sick.  A  tenderness,  how- 
ever, to  the  failings  of  those  who  had  been  his  pupils 
was  quite  a  marked  trait  in  his  character.  Early  ac- 
knowledged by  the  profession  as  the  great  man  of 


112  INTERCOURSE    WITH    PATIENTS. 

that  region  of  the  country,  he  became  at  length,  says 
one  of  my  correspondents,  "  the  autocrat  of  surgical 
matters  over  an  immense  body  of  the  profession, — 
the  great  operator  and  the  grand  arbiter  of  all  their 
surgical  disputes."  He  had  a  beautiful  faith  in  the 
profession  as  a  body.  If  any  one  told  him  that 
other  physicians  had  spoken  ill  of  him,  he  would 
always  try  to  explain  the  fact  in  the  most  favorable 
manner,  or  he  would  laugh  it  away  with  the  sunny 
remark,  "  No !  no !  he  is  a  clever  fellow,  he  never 
said  so  of  me.     You  are  mistaken." 

At  the  first  introduction  of  patients  to  Dr.  Twit- 
chell,  there  seemed  to  some  a  certain  degree  of 
stern  brusquerie  about  his  manners,  that  was  rather 
repulsive.  Women,  in  an  especial  manner,  seemed 
to  fear  an  unkind  and  perchance  coarse  mind.  But 
how  soon  did  they  discover  their  mistake  !  for  the 
liveliness  of  his  conversation,  his  thoughtfulness  of 
their  peculiar  state  of  mind,  and  his  almost  feminine 
delicacy  of  sentiment,  quickly  overcame  their  doubts. 
He  was  to  them  gentle  as  a  mother,  and  perfectly 
regardful  of  all  those  little  niceties  of  expression 
which  a  true  regard  for  woman  begets  in  any  manly 
soul.  I  do  not  mean  by  this  expression,  that  he 
indulged  in  small  talk,  and  the  infinitesimal  nothings 
with  which  some  think  they  should  address  a  female. 
Far  from  it.  His  tenderness  towards  the  other  sex 
arose  from  a  delicate  regard  for  the  noble  nature  of 
woman,  which  springs  naturally  up  in  the  heart  of  a 
great-minded  man.  How  versatile  his  talent  for 
winning  away  the  thoughts  of  the  sick  man  from  his 
despondency,  or  of  the  woman  from  her  restlessness  ! 


INTERCOURSE    WITH    PATIENTS.  113 

How  soothing  the  pressure  of  his  hand  as  he  sat  by 
the  side,  and  told  perhaps  of  merry  scenes  that  were 
enacting  abroad  !  What  admirable  adaptation  of 
language  and  sentiment,  so  as  just  to  suit  the  tem- 
perament, age,  and  sex  of  his  patient !  #  Early  in 
his  practice  he  formed  a  high  estimate  of  the  moral 
power  which  the  physician  may  exert.  Hence  he 
sought  always  to  control  the  mind  of  the  invalid, — 
knowing  full  well  that  thereby  he  should  wield  a 
mighty  lever  for  the  perfect  restoration  to  health. 
Thinking  very  little  of  his  fees,  but  much  about  the 
cure  of  his  patient,  he  was  equally  devoted  to  the  rich 
and  the  poor.  His  tenderness  and  consideration  for 
the  feelings  of  the  poor  have  been  mentioned  to  me 
by  some  of  them  with  deep  emotion.  The  result  was, 
that  all  looked  to  his  visits  as  the  brightest  hours  of 
the  day.  One  of  my  correspondents,  to  whom  I  am 
much  indebted  for  the  earnest  interest  he  has  taken 
in   giving   me   a  life-like   sketch  of  Dr.   Twitchell, 

*  I  cannot  forbear  quoting  the  following,  written  to  me  by  one 
whose  strong  mind  renders  her  fully  capable  of  appreciating  intel- 
lectual and  moral  greatness,  while  at  the  same  time  her  sex  teaches 
her  to  value  delicacy  of  thought  and  of  action :  "  Dr.  Twitchell' 8 
tender-heartedness,  concealed  under  his  rough  exterior,  was  an- 
other very  beautiful  point  in  his  character.  I  remember,  on  the 
occasion  of  the  death  of  a  brother  of  mine,  I  had  been  quite 
shocked  with  his  apparent  indifference  during  the  illness  ;  but, 
after  his  death,  which  occurred  perhaps  at  2  a.m.  he  spent  nearly 
the  remainder  of  the  night  with  us,  uttering  thoughts  full  of 
consolation  and  wisdom.  The  next  day,  too,  looking  at  the  little 
face,  he  said,  '  This  reminds  me  of  Byron's  lines,  — 

Before  decay's  effacing  fingers 

Have  swept  the  lines  where  beauty  lingers.' 

It  was  an  unexpected  revelation  of  sweetness  and  refinement,  for 
which  I  was  not  prepared." 
10* 


114  PRACTICAL    TACT. 

writes  thus  :  "  The  influence  of  his  conversational 
powers  in  a  sick-room  cannot  be  described.  The 
first  time  he  visited  me  in  a  protracted  illness,  hardly 
a  word  was  said  about  my  case  ;  and  yet,  by  amus- 
ing and  apparently  irrelevant  stories,  he  had  managed 
to  let  me  understand  my  condition  better  than  I  ever 
had  before,  and  to  leave  in  my  mind  a  conviction 
that  he,  at  least,  knew  all  about  it.  I  have  never," 
he  continues,  "  in  more  than  two  or  three  instances, 
met  a  man  who  has  given  me  so  decided  an  impres- 
sion of  a  strong  original  genius.  No  man  could  be 
less  formal,  or  more  entirely  without  pretension. 
His  professional  skill,  to  us  out  of  the  profession, 
seemed  like  intuition." 

Another  correspondent  says  "  he  had  a  great  deal  of 
what  is  called  practical  tact.  His  extensive  business 
rendered  time  precious  to  him ;  but  in  the  sick-room 
he  seldom  appeared  to  be  in  haste.  He  would  listen 
patiently  ;  but,  by  a  few  questions,  he  would,  without 
seeming  to  interrupt,  cut  short  the  details  of  the  sick 
person,  or  of  the  attendants,  and  proceed  forthwith 
to  give  his  directions.  Some  persons  of  his  own  pro- 
fession, on  their  first  acquaintance  with  him,  regarded 
him  as  too  hasty  in  his  diagnostic  conclusions ;  but 
they  soon  found  that  it  was  not  best  to  question  their 
correctness,  for  the  result  of  further  examination 
was  pretty  certain  to  verify  the  accuracy  of  his 
judgment." 

Some  amusing  anecdotes  are  told  of  his  eventful 
career  of  practice,  illustrative  of  his  influence  over 
patients.  He  used  to  say,  "  When  a  person  sends 
for  von  from  a  great  distance,  you  may  be  sure  that 


ANECDOTES.  115 

he  will  be  better  for  your  visit,  whatever  may  be 
your  prescription." 

An  old  woman  called  on  him  to  be  relieved  of  a 
tumor,  which  she  was  fearful  would  eventually  de- 
stroy her  life.  Dr.  Twitchell  found  it  was  of  such  a 
character  as  not  to  be  injurious,  if  the  patient  could 
be  persuaded  to  give  up  touching  and  thinking  so 
constantly  upon  it.  Accordingly,  he  prescribed  a 
simple  ointment,  to  be  applied  at  certain  stated  and 
distant  periods ;  and  that,  during  the  intervals,  the 
part  should  not  be  touched.  He  assured  her  she 
would  get  well,  if  she  would  implicitly  pursue  his 
directions.  Having  entire  confidence  in  her  physi- 
cian's powers,  she  followed  to  the  exact  letter  every 
rule  he  laid  down,  and  a  cure  was  the  result. 

The  following  was  related  to  me  by  the  patient 
himself:  Some  thirty  years,  or  thereabouts,  a  cou- 
ple of  worthy  deacons  were  travelling  for  pleasure  in 
their  own  one-horse  chaise,  towards  the  White  Moun- 
tains. In  their  dispositions,  they  might  be  said  to 
be  fair  representatives  of  the  difference  between 
L' Allegro  and  II  Penseroso.  Under  these  names, 
therefore,  I  shall  continue  my  tale.  Penseroso,  being 
somewhat  of  an  invalid,  resigned  most  of  the  active 
duties  of  a  traveller  to  his  more  jovial  friend ;  and 
so,  jogging  on  together,  they  were  a  mutual  aid  and 
source  of  contentment.  Hard  by  Keene,  however, 
are  some  very  rough  mountains,  as  Dr.  Twitchell 
well  knew  by  experience,  and  which  our  worthy 
friends  were  destined  to  learn  by  experience,  still 
more  dire ;  for  suddenly,  while  descending  a  wind- 
ing road,  L' Allegro's  powers  of  driving  were  set  at 


116  ANECDOTES. 

nought ;  the  chaise  was  npset,  and  both  were  thrown 
heavily  to  the  ground.  By  dint  of  the  assistance  of 
passers-by,  they  were  set  upon  their  journey  again. 
But  it  was  no  longer  a  laughing  matter  for  poor 
L* Allegro;  for  every  time  an  uneven  place  occurred 
in  the  road,  or  even  a  disposition  to  be  merry  came 
over  him,  and  the  action  was  suited  to  the  thought, 
he  was  seized  with  a  most  violent  pain  in  the  side  of 
the  chest.  He  said  nothing,  however,  for  fear  of 
disturbing  the  equanimity  of  his  pensive  companion, 
and  rode  on  with  the  trouble  gradually  augmenting, 
until  it  seemed  to  him  as  if  the  slightest  approach  to 
a  laugh  was  agony.  Arrived  at  Keene,  he  informed 
Penseroso  that  they  must  resign  their  respective 
duties.  He  himself  must  now  be  the  patient,  and  he 
hoped  his  friend  would  assume  the  responsible  duties 
of  nurse.  Meanwhile,  however,  he  begged  that  his  old 
friend  Twitchell  might  be  sent  for.  One  can  readily 
imagine  the  unhappy  state  of  things,  when  two  inve- 
terate jokers  and  old  friends  meet,  and  have  to  restrain 
their  mirth.  "  I  must  bleed  you,"  said  the  doctor. 
"For  Heaven's  sake  don't!  "  gasped  the  sick  man; 
11  I  never  could  bear  the  sight  of  blood  without  faint- 
ing, and  I  shall  certainly  faint  with  the  first  drop  I 
see  of  mv  own  !  "  The  doctor  said  nothing  more 
about  bleeding,  but  began  talking  in  his  old  jovial 
strain,  and  immediately  the  mind  of  his  friend  was 
transported  to  scenes  long  past,  and  revelled  in  the 
jokes  of  former  days.  Meanwhile,  the  preparations 
for  bleeding  wTent  silently  on ;  the  arm  was  bound 
up  ;  even  the  vein  was  opened,  and  still  no  tremor: 
no  serious  thought  on  the  part  of  the  patient  of  what 


ANECDOTES.  117 

was  going  on ;  and  finally,  at  the  termination  of  the 
whole  operation,  he  concluded  that  he  would  sub- 
mit willingly  to  be  bled  by  such  a  man  as  Twitchell 
every  week  of  his  life !  He  had  really  made  a 
pastime  of  what  had  been  so  dreaded.  This  patient 
soon  recovered,  and  now  lives  in  the  genial  atmos- 
phere of  a  happy  and  robust  age,  enjoying  the  plea- 
sures of  a  well-spent  life.  He  fully  appreciated  the 
real  value  of  his  early  friend,  when  he  said  to  me  in 
the  last  interview  I  had  with  him  :  "  If  I  had  not  seen 
Twitchell  for  twenty  years,  we  should  have  met 
however  as  boys,  so  hearty  and  youthful  did  his  tem- 
perament remain  to  the  last.  I  never,"  he  added, 
"  was  in  TwitchelPs  society  half  an  hour,  without 
finding  something  in  his  conversation  that  was  ori- 
ginal, refreshing,  and  exhilarating." 

Another  anecdote  illustrative  of  his  rapid  diag- 
nostic powers  and  of  his  quaint  prescriptions  may 
be  told.  He  was  riding  one  day  rapidly  onward 
to  meet  an  appointment,  and  had  stopped  on  the 
banks  of  a  river  for  the  ferry-boat  to  return.  The 
rumor  of  Dr.  Twitcheli's  presence  being  noised 
abroad,  a  neighboring  devotee  of  St.  Crispin  rushed 
forth  from  his  hammer  and  last  to  consult  him.  The 
doctor  was  in  his  sulky,  and,  having  only  a  few 
moments  to  spare,  cried  out,  "Go  into  the  house  and 
boil  your  hammer,  and  touch  it  to  the  part."  Saying 
this,  Dr.  Twitchell  sprung  from  his  vehicle,  and,  hav- 
ing heated  the  hammer  in  the  good  housewife's  pot 
of  boiling  water,  applied  it  with  instant  relief  to  the 
part  affected.  I  have  understood  from  good  autho- 
rity, that  the  sufferer  never  had  another  paroxysm, 


118  SCORN    OF    QUACKERY. 

and  the  surgeon  was  considered  as  having  performed 
a  miracle.  The  prescription,  however,  was  not  origi- 
nal; the  peculiar  method  of  applying  it  was  his  own. 

At  times  he  was  very  violent,  and  especially 
was  this  the  case  with  those  who,  knowing  the  right, 
still  did  wrongly.  Such  a  course  being  so  entirely 
contrary  to  his  own  principles  of  action,  he  retained 
no  patience  for  any  one  who  followed  it.  On  one 
occasion,  a  man,  whose  family  he  had  attended,  and 
who  was  himself  known  to  be  intemperate,  called 
him  very  hastily  to  go  to  see  his  daughter.  "  I  wont 
go,"  said  the  doctor.  "  For  God's  sake,"  replied 
the  agonized  father,  "  go  and  see  my  child,  and  I 
will  pay  you  what  you  ask,  or  work  for  you  as  long 
as  you  wish."  "  I  wont  go,"  again  sternly  shouted 
the  doctor  ;  "  you  may  offer  whatever  you  wish,  and 
you  will  not  persuade  me ;  but,  if  you  will  promise 
to  give  up  your  beastly  intemperance,  to  become  an 
honest  man,  and  to  take  care  of  your  family,  then  I 
will  hereby  agree  to  attend  you  all  for  nothing." 
Rumor  does  not  say  whether  the  pledge  wras  taken. 
The  doctor  is  believed  to  have  seen  the  patient. 

Dr.  Twitchell  scorned  all  quackish  cajoling  of 
patients,  and  despised  that  pettiness  of  soul  which 
some  of  our  most  eminent  practitioners  avow  and 
act  upon ;  namely,  that  there  must  be  some  air  of 
mystery  around  the  recipe  of  a  physician.  To  those 
who  say  that  a  physician  cannot  succeed  in  gaining 
an  honorable  practice,  if  he  talk  freely  with  his 
patients  upon  their  diseases  and  his  own  treatment, 
I  might  quote  Dr.  Twitchell  as  an  illustrious  ex- 
ample of  the  falsity  of  their  views.     He  conversed 


OPERATIONS.  119 

with  perfect  openness,  and  was  not  afraid  even  to  con- 
fess that  he  had  erred  in  his  diagnosis  or  his  treat- 
ment. To  me  this  seems  a  trait  of  surpassing 
beauty ;  for  "  to  err  is  human,"  to  be  willing  to 
confess  that  error  is  divine.  His  desire  to  avoid  all 
circumlocution,  and  to  state  precisely  what  he 
thought  and  in  the  plainest  manner,  led  him  to  avoid 
the  use  of  Latin  in  his  prescriptions,  and  the  usual 
heathenish  symbols  of  measures  and  weights  that 
have  descended  from  the  dark  days  of  our  profession 
until  now. 

In  his  operations,  he  was  slow,  deliberate,  and  con- 
scientious. I  have  elsewhere  mentioned,  that  as  a  boy 
his  feelings  were  so  tender  that  he  would  weep  at 
the  sight  of  a  cat  torturing  a  mouse ;  yet  in  after-life 
he  dared  to  perform  any  operation  upon  the  human 
frame.  How  shall  we  account  for  this  ?  Not  cer- 
tainly from  any  callousness  having  gradually  come 
over  the  fine  structure  of  his  heart ;  for  on  the  nights 
preceding  all  operations  he  was  restless,  and  uneasily 
inquiring,  "  Is  it  right  for  me  to  operate  ?  Would  I, 
were  I  similarly  circumstanced,  allow  the  same  ope- 
ration to  be  made  upon  me,  or  any  of  my  family  ?  " 
But,  when  he  came  to  the  hour  for  operating,  he  was 
cool  and  calm  as  a  man  at  prayer.  Was  that  heart 
hardened  to  the  sight  of  human  suffering  ?  Oh,  no  ! 
far  from  it.  It  was  ready  to  gush  forth  with  the  ten- 
derest  emotions ;  but  duty  called  upon  him  to  stifle 
them,  and  he  did  so.  It  is  not  true  that  the  practice 
of  medicine  or  surgery  leads  to  carelessness  of 
human  life  and  suffering,  as  some  ignorantly  sup- 
pose. 


120  DOMESTIC    DISCIPLINE. 

For  several  years  before  his  death,  he  had  a  pri- 
vate hospital  of  his  own  ;  and  his  devotion  to  all  the 
really  sick  and  suffering,  whatever  might  be  their 
condition,  was  admirable.  He  has  been  known  to 
leave  his  own  house  and  visit  them  several  times 
during  the  night,  in  order  that  they  might  not  suffer. 
They  were  all  regarded  as  his  children  ;  for  whether 
rich  or  poor,  beautiful  or  ugly,  or  afflicted  with  loath- 
some disease,  —  to  each  and  all  were  his  attentions 
unceasing. 

In  his  intercourse  with  the  immediate  members  of 
his  household,  he  was  proverbially  benignant.  Stern, 
slightly  abrupt,  and  perhaps  a  little  irritable,  he  might 
be  at  times,  on  his  return  from  long  and  fatiguing 
drives,  but  never  violent.  Almost  a  spoiled  child,  as 
he  was  in  certain  respects,  by  the  tenderness  of  his 
wife,  every  thing  was  yielded  to  him  on  such  occa- 
sions. Every  noise  must  be  stilled.  Even  the 
merry  tones  of  childhood,  when  bursting  forth  like 
the  joyous  notes  of  the  birds  in  spring,  were  hushed. 
The  doctor  usually  threw  himself  upon  his  sofa, 
covered  his  face  with  his  handkerchief,  and  either 
seemed  to  be  or  did  actually  fall  asleep.  At  times, 
however,  some  of  the  more  roguish  of  his  young  com- 
panions would  test  his  powers  of  endurance ;  and, 
by  that  winning  way  which  childhood  alone,  in  its 
beautiful  unconsciousness,  knows  how  to  tread,  per- 
suade him  to  forget  his  fatigue  of  body  and  the  various 
discomforts  arising  from  his  intercourse  with  man,  in 
perhaps  boisterous  merriment  with  the  child.  Alas  ! 
how  little  do  most  of  us  appreciate  in  older  life  the 
rich  enjoyment  we  might  experience,  if  we  would  only 


LOVE    OF    CHILDREN".  121 

have  perfectly  unfettered  intercourse  with  the  soul  of 
childhood  !     As  nothing  mortal  can   be  more  fra- 
grant than  the  babe  in  its  mother's  arms  just  emerg- 
ing from  its  morning  bath,  so  in  the  spiritual  world 
nothing  can  be  to  us,  in  the  meridian  or  decline  of 
life,  so  pure  or  holy  as  the  native  outgushing  confi- 
dence and  love  writh  which  a  child  will  always  nestle 
to  the  bosom  of  one  older  than  itself.     The  ages  are 
complements  of  each  other.     An  orphan  girl  and  a 
childless  old  man  are  correlative  terms.    Thrice  hap- 
py are  they  who,  while  the  cares  of  the  world  have 
been  gradually  enclosing  them,  have  still  kept  their 
hearts   so   warm  that   even    the  vivacious   roguery 
of  childhood  will  lighten  instead  of  increasing  their 
already  heavy  burdens.     Dr.  Twitchell  was  such  a 
one.     There  are  those  now  alive  who  will  remember 
the  quiet  and  peculiar  laugh  with  which  on  such  oc- 
casions their  stealthy  touch  of  the  apparent  sleeper 
was  sometimes   greeted ;  and  how  they  climbed  at 
last,  unchecked  in  their  wildest  glee,  high  upon  his 
shoulders.     These  may  seem  minute  details  ;  but  to 
my  mind  they  illustrate  one  of  the  fairest  traits  of  his 
character.     Need  I  remind  those  who  once  were  the 
recipients  of  his  bounty,  of  those  formidable-looking 
pockets  with  which  he  entered  the  house  on  Christ- 
mas-eve ?     What  a  multitude  of  questions  as  to  their 
contents,  and  what  earnest  efforts  of  young  hands  to 
enter  the  forbidden  precincts !     Can  those  who  then 
were  young  ever  forget  the  mock-heroic  and  stern 
style  with  which  all  points  of  approach  were  guarded, 
while  the  formidable  words  "  medicines,"  "  you  must 
not  touch,"   &c.  were   wholly  contradicted  by  that 
11 


122  FAMILY    DISCIPLINE. 

peculiar  twinkle  of  his  eye,  and  the  inimitable  half- 
suppressed  laugh,  so  suggestive  of  a  merry  soul,  and 
which  was  as  Tivitchellian  in  its  characteristics  as  the 
roll  of  Dr.  Johnson's  huge  frame  was  all  his  own  ? 
The  heavily-laden  stockings  of  the  young  folks  al- 
ways subsequently  proved  the  generosity  of  their 
domestic  Santa  Claus. 

At  times  he  was  called  upon  to  rebuke  for  wrong- 
doing the  young  people  under  his  charge.  How 
shall  I  describe  his  rebukes,  which  were  not  so  much 
in  words  as  in  the  depth  and  tenderness  of  his  tones, 
rather  of  grief  than  of  anger  ?  On  such  occasions 
his  words  pressed  like  hot  iron  into  the  heart  of 
the  offender,  leaving  indelibly  impressed  the  idea 
of  its  error,  and  bringing  a  determination  never  to 
do  a  like  deed.  It  will  be  seen  by  this  that  he  was 
by  no  means  a  believer  in  Solomon's  rule  of  the  rod. 
The  wise  man  therein  fails  of  reaching  the  loftiest 
wisdom ;  that  is,  if  we  take  the  passage  in  its  literal 
sense.  As  a  metaphor,  and  as  meaning  discipline, 
Dr.  Twitchell  had  an  entire  confidence  in  the  doc- 
trine. Who,  in  fact,  could  think  otherwise  ?  But 
he  was  not  satisfied  with  merely  playing  with,  or 
correcting,  the  children  that  were  under  his  influence. 
Philosopher-like,  he  desired  that  some  instruction 
should  be  generally  mingled  with  their  sports.  He 
had  no  regular  hours  of  study  with  them ;  but  he 
often  taught  them  while  they  were  silting  upon  his 
shoulder,  —  a  favor  which  he  granted  a  longer  or 
shorter  time,  according  to  the  attention  paid  by  them 
to  his  instruction.  Not  seldom  did  he  summarily  drop 
one  of  his  young  friends  from  that  place  so  attractive 


RELIGIOUS    VIEWS.  123 

to  a  child,  on  the  first  evidence  of  carelessness  in 
giving  heed  to  his  words. 

Nothing  is  more  interesting  to  me  than  the  con- 
templation of  the  earnest  inquiries  of  a  strong  soul 
after  philosophical  and  religious  truth.  The  religious 
sentiment  being  the  first  around  which  all  others 
must  revolve  at  one  time  or  another  during  one's 
earthly  life,  and  the  idea  of  Deity  being  the  greatest 
that  any  human  being  can  grapple  with,  we  naturally 
turn  with  some  anxiety  to  learn  what  any  great  man 
thinks  on  the  subject.  I  have  sought  to  obtain  cor- 
rect views  of  the  opinions  of  Dr.  Twitchell  upon 
the  nature  of  man,  and  of  his  relations  to  others  of 
God's  creatures.  I  have  endeavored  also  to  find  out 
his  opinions  in  regard  to  God  and  Christ.  Surely 
no  nobler  themes  for  contemplation  can  be  presented 
to  the  human  mind  !  I  would  premise  that  I  never 
conversed  with  him  upon  these  great  topics,  and 
the  following  statements  rest  upon  the  evidence  of 
others.  A  correspondent  says,  "  On  religious  sub- 
jects he  was  reserved.  He  supported  the  institutions 
of  Christianity ;  but  if  any  one  attempted  to  draw 
him  out,  and  get  his  distinctive  views  on  questions  of 
controversy,  the  inquirer  would  find  himself  defeated. 
He  could  hardly  tell  how ;  for  the  doctor  kept  on  talk- 
ing, and  generally  ended  by  getting  the  questioner 
interested  in  some  other  topic,  so  that  the  subject  of 
his  inquisitiveness  was  forgotten." 

There  seems  to  be  no  doubt  that  his  tendencies 
were  not  towards  the  highest  spiritualism,  while  at 
the  same  time  he  denied  that  a  materialist  view  of 
the  universe  was  inconsistent  with  the  doctrine  of  the 


124  RELIGIOUS    VIEWS. 

immortality  of  man,  which  he  fully  held.  His  view 
of  the  creation  was  that  now  adopted  by  some  of  the 
most  able  writers  of  the  present  day,  viz.  that, 
in  the  Almighty's  system,  man  and  the  smallest  of 
the  zoophytes  form  but  two  extremities  of  one  vast 
chain  of  life.  He  thus  linked  himself  with  all  beings 
of  a  higher  or  a  lower  order,  as  we  usually  estimate 
them,  but  which  are  only  different  parts  in  the  one 
great  plan  of  God.  According  to  Dr.  Twitchell,  man 
is  endowed  with  intelligence,  in  consequence  of  his 
higher  physical  organization.  The  chimpanzee  is 
his  " cousin,"  however  "ugly"  he  may  be;  and  the 
horse  knows  well  his  voice,  and  reasons  with  him. 
With  the  nature  of  God  he  troubled  himself  but 
little ;  probably  esteeming  it  as  a  subject  far  above 
his  comprehension.  To  the  Unity  and  Trinity,  and 
other  minor  views  held  by  various  sects,  he  paid  no 
attention ;  although  he  told  a  friend  who  asked  him 
to  subscribe  for  an  orthodox  work,  that  he  was  "  as 
much  orthodox  as  any  thing."  As  I  view  him,  his 
soul  was  too  great  to  be  trammelled  by  any  of  the 
puny  creeds  that  divide  the  world.  Perhaps  he 
would  have  agreed  with  Aime  Martin,*  that  "  mere 
sects  are  impieties  before  God."  God  to  him  was 
an  ever-present,  eternal,  illimitable,  beneficent  Being, 
who  knew  all  his  thoughts,  and  looked  kindly  even 
upon  his  errors.  He  regarded  him  as  a  Father  rather 
than  as  a  Judge,  and  quietly  rested  in  that  faith,  even 
till  the  last  hour  of  his  life. 

Another  of  his  friends,  in  a  letter  to  me,  says,  "  I 

*  Education  des  Meres. 


RELIGIOUS    VIEWS.  125 

have  heard  him  declare  his  unqualified  belief  in  God 
and  immortality.  I  have  heard  him,  while  holding 
the  dissecting-knife  in  his  hands  and  pointing  out  the 
delicate  structure  of  the  valves  of  the  heart,  or  some 
other  wonder  of  our  frame,  repeat  with  earnest 
emotion  the  lines  of  the  poet :  — 

•  Strange  that  a  harp  of  thousand  strings 
Should  keep  in  tune  so  long.' 

He  dwelt  feelingly  on  the  goodness  and  skill  of  God 
in  the  creation,  and  enjoined  it  upon  one  of  his  mor- 
bidly disposed  patients  to  turn  to  their  contemplation 
as  a  remedy  for  his  dark  thoughts." 

He,  however,  rarely  attended  church.  Probably 
this  was  owing  in  some  degree  to  the  fact,  that  his 
extensive  business  occupied  most  of  his  time.  In 
later  life,  his  health  would  have  prevented.  I  ques- 
tion much,  however,  whether  he  was  not  one  of  those 
who  feel  that  the  services  of  the  church  have  lost  for 
them  most  of  that  holy  unction  with  which,  in  ages 
gone  by,  they  used  to  impress  the  hearts  of  all  wor- 
shippers. He  perceived,  moreover,  in  his  intercourse 
with  the  world,  that  men  too  frequently  seem  to  think 
that  attendance  regularly  upon  divine  worship  twice 
each  sabbath  absolves  them  from  a  life  of  stern 
integrity,  instead  of  strengthening  them  to  high  re- 
solves and  perfect  truth.  In  his  jocose  manner,  he 
used  to  say  that  a  deacon  cheated  him  on  a  week- 
day worse  than  any  one.  Yet  he  had  a  sincere  and 
hearty  respect  for  a  devoted  and  active  minister  of 
religion.  No  one  ever  had  a  higher  regard  than  he 
11* 


126  RELIGIOUS    VIEWS. 

had  for  a  man  like  that  noble  ideal  given  by  Herder 
of  the  -Preacher  of  God."* 

"  The  manifestations  of  piety,"  says  one  of  my 
correspondents,  "  he  always  treated  with  respect." 
I  may  add,  that,  when  he  perceived  a  true  heart  was 
the  cause  of  it,  even  religious  oinciousness  and  im- 
pertinence always  met  with  kindness  from  him.  A 
remarkable  illustration  of  this  occurred  several  years 
ago.  A  female  of  his  acquaintance,  while  under 
high  religious  excitement,  called  upon  him,  and  said 
she  had  an  important  matter  on  which  she  wished 
to  converse  with  him.  She  seemed,  however,  to 
shrink  from  speaking,  for  fear  of  giving  offence.  He 
begged  her  to  proceed  with  the  utmost  frankness, 
and  assured  her  that  she  could  say  nothing  that  would 
offend  him.  She  then  stated  that  she  had  been 
called  by  God  to  speak  with  him  boldly  upon  the 
state  of  his  soul.  She  felt  that  he  was  living 
alienated  from  God,  that  he  should  awaken  from  his 
lethargy,  and  prepare  by  religion  and  the  church  for 
death,  which  might  happen  to  him  at  any  moment. 
Having  heard  her  with  much  gentleness,  he  thanked 
her  for  her  kind  thoughts  on  his  behalf,  and  said  that 
he  honored  her  for  her  frankness,  at  which  he  could 
not  for  a  moment  take  offence.    He  concluded  thus : 

*  "  He  stands  in  the  midst  of  his  friends  and  children.  They 
press  around  their  father ;  around  the  man  -who  is  anxious  for  the 
welfare  of  their  souls ;  who  knows  them  in  their  houses  and  in 
their  hearts ;  "who  consoles  them  in  the  troubles  of  this  life,  and  seeks 
their  happiness  for  eternity  ;  whom  they  know  as  a  pious,  upright, 
and  judicious  man,  who  speaks  every  word  from  the  heart.  lie  is 
the  Preacher  of  God  !  "  —  Christian  Examiner,  1835,  vol.  viii.  new 
series,  page  179. 


RELIGIOUS    VIEWS.  127 

"  But,  my  friend,  you  are  mistaken.  God  never 
told  you  to  call  on  me.  He  knows  my  heart  better 
than  any  one  else,  and  I  know  that  he  never  sent 
you.  Qur  prayers,"  he  said,  "  should  arise  in 
every  action  of  our  lives,  and  we  should  be  con- 
stantly prepared  for  death  by  always  living  rightly." 
—  Noble  thoughts,  kindly  expressed  by  a  true 
heart !  * 

Of  hypocrisy  in  religion,  and  in  attending  reli- 
gious worship,  he  had  a  most  thorough  hatred  ;  and 
he  would  be  very  sure  to  apply  the  lash  of  his 
cutting  but  quiet  humor  whenever  he  saw  evidences 
of  this  meanness.  He  spared  neither  high  nor  low. 
Anecdotes  might  be  related  illustrative  of  his  keen- 
ness, but  generally  modified  by  his  excellent  good 
nature  on  such  occasions. 

His  views  of  Christ  and  of  his  religion  may  be  in- 
ferred somewhat  from  what  I  have  already  said. 
He  has  been  called  by  some,  "  an  aboriginal 
Christian  ;  "  —  an  expression  which  seems  to  me  very 
happy,  and  exactly  descriptive  of  him.  In  those  great 
elements  of  a  religious  soul  and  Christian  life,  justice, 
truthfulness,  and  benevolence,  he  stands  pre-eminent. 
His  great  reverence  for  goodness  and  for  natural 
simple  piety,  wherever  found,  prove  that  he  had  a 
corresponding  chord  in  his  own  bosom.  Above  all, 
the  calmness  which  possessed  his  soul  at  the  approach 
of  death  indicates  the  religious  spirit,  although,  as 

*  I  have  been  told,  that,  when  this  good  woman  appealed  to 
the  doctor  to  allow  her  minister  to  call  upon  him,  and  talk  with 
him  about  religion,  he  told  her,  rather  irreverently  perhaps,  that 
he  could  teach  her  minister  his  A  B  C  of  religion. 


1*23  RELIGIOUS    VIEWS. 

one  correspondent  says,  he  went  not  to  that  bourne 
by  the  way  of  the  church. 

Yet  he  was  not  a  Christian,  if  a  belief  in  the 
miraculous  birth  and  acts  of  the  divine  Founder  of 
the  religion  of  love  be  necessary  to  justify  one  in 
assuming  this  epithet.  The  miracles,  as  such,  were 
to  him  no  proof  of  a  divine  mission.  Nay,  truth 
compels  me  to  say,  that  they  were  an  absolute 
stumbling-block  to  him.  They  marred  the  holy 
beauty  of  Christ's  character  and  life,  instead  of 
deepening  Dr.  Twitchell's  reverence  for  that  noble 
being.  I  say  this  in  sorrow,  and  thrice  happy  are 
we  who  can  look  without  difficulty  through  them  or 
over  them  at  the  transcendent  glories  of  that  life 
of  self-sacrifice.  Probably  these  views  may  have 
tended  to  prevent  his  attendance  upon  the  worship 
of  any  church  made  by  man.  His  church  was  the 
temple  of  all  nature,  and  his  hours  of  worship  were 
while  on  his  rides  on  professional  business  for  the 
relief  of  humanity.  "  How  can  any  one  help  ador- 
ing," he  said  once  to  a  near  friend,  "  if  he  will  ride 
as  I  do  some  early  morning,  and  see  the  break  of 
day  over  Monadnock  ?  I  observe  the  first  faintest 
trace  of  light,  and  watch  its  gradual  increase  until 
the  full  burst  of  the  sun  over  the  highest  peak  brings 
to  me  the  idea  of  a  God.  People  lose  half  the  beauty 
of  their  lives  by  not  being  up  to  enjoy  such  scenes." 
It  was  fitting  that  such  a  man  should  have  been  born 
at  the  base  of  the  mountain  of  the  Great  Spirit.  It 
was  under  its  benign  influences,  exerted  upon  him 
from  earliest  years,  that  he  learned  to  enjoy  that 
hill-side  species  of  worship,  belonging  to  "  absolute 


RELIGIOUS    VIEWS. 


129 


religion  "  alone,  to  which  I  alluded  in  the  earlier  part 
of  this  memoir,  and  which,  growing  with  his  increas- 
ing years,  became  at  last  one  of  the  strongest  ele- 
ments of  his  character.  "  But  he  did  not  believe  as 
we  do,"  cries  the  bigot.  Be  it  so.  I  grant  that  his 
speculative  faith  differed  from  that  usually  held 
sacred  by  Christians  of  the  present  day.  But  did 
he  not  act  out  in  common  life  the  principles  of 
Jesus  ?  And  how  can  any  one  doubt  his  practical 
belief  in  those  principles,  when  we  see  him  daily 
going  about  doing  good  ?  His  profession  was  not  a 
mere  money-making  trade,  but  a  noble  art,  which  he 
wielded  in  the  service  of  humanity.  His  religion, 
like  that  of  Abou  Ben  Adhem's  in  Eastern  poetry, 
consisted  more  in  acts  of  practical  good-will  to 
man  than  in  talk  of  his  love  to  God.  All  ages  were 
attracted  to  him.  To  the  little  children  gathered 
around  him  upon  the  door-step,  he  told  pleasant 
tales,  and  they  loved  him ;  the  middle-aged,  when 
in  joy  or  sorrow,  found  a  sympathizing  chord  in 
his  heart ;  the  sick  and  aged  relied  upon  his  visits 
and  his  conversations,  ever  pure  and  hopeful,  for  the 
support  of  their  souls.  To  none  did  his  religion 
ever  bring  aught  inconsistent  with  temperance,  jus- 
tice, and  truth.  Surely,  if  he  be  not  worthy  of  the 
Christian  name,  I  pray  Heaven  we  may  have  many 
more  such  men  among  us  Christians;  and  I  feel 
certain,  that,  in  so  saying,  I  express  a  thought  which 
will  be  warmly  reciprocated  by  all  who  knew  and 
duly  appreciated  him. 


130 


CHAPTER   VIII. 


FROM    1S43   TO   1850.  JET.   67—69. 


My  ovm.  Acquaintance.  —  Personal  Appearance.  —  Conversations. 
—  Instinct  and  Reason.  —  Medical  Chemistry.  —  Cure  of  Him- 
self by  Strict  Diet.  —  Account  of  his  Cases  dictated  to  me  by 
Himself.  —  Jocose  Man.  —  Anecdote  of  old  "  Bucephalus."  — 
My  delightful  Reminiscences  of  him.  —  Last  Illness  and  Death. 

I  remember  well  the  first  time  I  met  Dr.  Twitchell. 
It  was  in  the  spring  of  1346,  and  I  had  just  alighted 
from  the  cars  at  Keene.  I  had  no  thought  of  meet- 
ing him,  as  I  was  at  that  time  unaware  of  his  habit 
of  resorting  to  the  station-house  on  the  arrival  of  the 
cars.  I  had,  however,  long  known  him  as  the  great 
surgeon  of  the  three  Northern  or  Eastern  States.  I 
glanced  around,  and  was  struck  with  the  appearance 
of  one  man.  I  said  immediately,  "  That  must  be 
Dr.  Twitchell.  Two  such  heads  cannot  be  found 
in  one  New  England  village."  Subsequently,  I 
found  that  my  diagnosis  had  been  correct.  He  was 
a  man  somewhat  beyond  the  noon  of  life.  He 
moved  about  actively,  but  with  a  semi-shuffling  gait. 
He  was  below  the  medium  height,  of  a  large  and 
farmer-like  figure,  which  was  awkwardly  set  off 
by  an  old-fashioned  blue  coat  that  hung  loosely 
upon  his  body.  He  looked  at  me  with  that  quiet, 
searching    glance   habitual   to   him.      His  massive 


INSTINCT    AND    REASON.  131 

head,  half  covered  as  it  was  with  a  hat  that  had  seen 
many  summers,  gave  instant  evidence  of  its  intellec- 
tual power.  The  traces  of  a  benevolent  heart,  which 
flitted  occasionally  over  the  face,  confirmed  my  opi- 
nion that  he  was  no  other  than  Twitchell.  His  eye 
I  never  shall  forget.  It  was  small,  gray,  and  mildly 
piercing,  yet  modest  and  retiring ;  and,  though  half 
hidden  under  its  thick,  shaggy  brows,  I  fell,  by  its 
very  depth,  the  intensity  of  his  gaze.  Soon  after 
this,  I  became  personally  acquainted  with  him  ;  and 
we  had  many  conversations,  profitable  to  myself, 
during  that  visit  and  at  subsequent  periods. 

Among  these  conversations,  I  may  quite  cursorily 
allude  to  the  following :  A  discussion  had  arisen 
among  a  party,  while  seated  around  his  own  tea- 
table,  on  the  difference  between  instinct  in  animals 
and  reason  in  man.  Some  of  the  company  limited  the 
possession  of  reason  to  man,  and  were  equally  dis- 
posed to  deny  instinct  to  him.  Dr.  Twitchell's  face 
lighted  up  as  he  took  the  opposite  view.  The  young 
of  man  and  of  all  animals  seek  instinctively  their  nou- 
rishment. Instinct,  therefore,  belongs  to  man  with 
the  lower  animals.  But  Dr.  Twitchell  was  too  old 
a  horseman  not  to  know  that  reasoning  powers 
existed  in  his  favorite  beast.  He  cited  instances  of 
memory  and  reflection  that  he  had  seen  in  the  lower 
animals.  Modern  science,  I  believe,  fully  confirms 
his  views.  If  you  take  the  young  star-fish  from  its 
parent,  and  put  it  on  the  opposite  side  of  the  vessel, 
the  mother  will  shortly  seek  her  child,  and  take  it 
again  under  her  maternal  charge.  You  may  call  this 
instinct   or  reason  as  you  please.      To  an  unpre- 


132  MEDICAL    CHEMISTRY. 

judiced  mind,  however,  it  seems  marvellously  like 
the  process  by  which  a  human  mother  would  seek 
her  lost  offspring.  Dr.  Twitchell  never  would  con- 
sent to  the  elevation  of  man  by  a  degradation  of  the 
brutes. 

In  medical  chemistry  he  was  much  interested. 
He  believed  that  upon  this  subject  the  dawn  was  but 
just  opening  on  medicine,  and  that  to  medical  che- 
mistry would  be  due  some  of  the  grandest  triumphs 
of  the  profession  in  future  times.  On  one  occasion 
he  said  to  me,  "  If  I  were  a  young  man,  I  would 
devote  myself  thoroughly  to  animal  chemistry.  I 
would  analyze  the  blood  and  every  organ  in  the 
human  body  while  in  health.  Having  done  this,  I 
would  repeat  the  same  processes  upon  man  in  a  dis- 
eased state."  These  views,  I  am  well  aware,  are 
very  different  from  those  held  by  the  body  of  the 
medical  profession.  In  fact,  too  many  physicians 
seem  to  regard  practical  chemistry  as  of  no  import- 
ance to  a  medical  man.  But  how  many  curious  and 
complex  processes  are  daily  carried  on  by  chemical 
laws  in  the  human  frame  !  Dr.  Twitchell  believed 
that  here  was  a  great  field  for  the  energy  of  the 
young  scientific  physician  to  display  itself  in  the  path 
of  discovery.  My  own  opinion  coincides  with  Dr. 
Twitchell' s  ;  but  it  seems  to  me  that  the  only  way  by 
which  a  general  elevation  of  the  profession  on  this 
point  can  be  attained  is  by  means  of  the  various 
medical  schools  of  the  country.  Practical  chemistry 
should  be  taught  in  every  school  as  practical  ana- 
tomy is  taught,  not  merely  by  lectures,  but  by  actual 
demonstrations. 


HIS    OWN    CASE.  133 

One  of  the  principal  subjects  of  our  conversation 
was  his  own  recovery  from  an  apparently  malignant 
disease,  by  means  of  diet  alone.  I  was  astonished 
at  that  history  ;  and  as  he  was  kind  enough  to  enter 
into  full  details  on  the  subject,  I  will  relate  it  here, 
very  nearly  as  it  was  printed  in  the  "  Charleston 
(S.C.)  Medical  Journal."*  It  will  give  the  reader 
an  idea  of  the  surpassing  power  which  he  had  over 
his  own  appetites,  while  it  affords  an  illustration  of 
the  influence  which  simple  diet  has  over  the  human 
frame.     The  history  is  as  follows :  — 

"  1.  Cancer  had  appeared  in  his  family.  His  grand- 
mother died  of  cancer  of  the  breast ;  his  sister,  of  that  of 
the  stomach.  These  are  all  the  data  of  his  hereditary 
tendencies  that  bear  upon  our  main  topic. 

"  2.  In  very  early  life,  Dr.  Twitchell  was  in  delicate 
health.  As  a  youth,  he  was  stronger,  and  was  among  the 
foremost  in  all  athletic  sports.  While  at  college,  he 
became  dyspeptic,  had  jaundice,  &c. ;  subsequently,  he 
passed  gall-stones.  Whilst  pursuing  the  studies  of  his 
profession,  he  began  to  suffer  from  asthma ;  and,  for 
about  twenty  years,  was  very  much  subject  to  violent 
attacks  of  it,  causing  him  during  the  winter  to  sit  up  in 
bed  half  of  every  night.  During  all  this  period  he  ate 
animal  food  very  freely,  three  times  every  day,  and 
digested  it  with  ease ;  whereas  vegetable  food  caused  dys- 
peptic difficulties.  Being  induced,  owing  to  a  severe 
eruption  of  the  face,  to  abandon  this  course,  he  gave  up, 
for  nine  years,  the  use  of  meat.  After  some  months,  his 
face  was  cured ;  and,  from  the  period  at  which  he  first 
abandoned  meat,  he  never  had  an  attack  of  asthma  ;   and 

•  The  Charleston  Medical  Journal  and  lleview,  Nov.  1849. 
12 


134  INFLUENCE    OF    DIET 

Dr.  Twitchell  considers  these  two  facts  related  to  each 
other  as  cause  and  effect.  Moreover,  vegetable  food  was 
soon  easily  borne.  After  the  nine  years  of  vegetable 
regimen,  he  began  gradually  to  resume  the  milder  kinds 
of  animal  food,  such  as  poultry  and  somewhat  of  the 
more  solid  meats,  until  two  years  since  (1847),  when  he 
commenced  the  very  rigid  diet,  to  be  described  when 
treating  of  the  local  disease  which  is  the  more  immediate 
object  of  this  paper.  Finally,  I  will  state,  as  indicative 
perhaps  of  the  tendencies  of  the  cutaneous  system  to 
morbid  action,  that  about  four  years  ago  he  had  a  papular 
eruption  lasting  six  weeks  ;  and,  likewise,  that  very  many 
years  ago  he  had  a  wart-like  tumor  on  the  scalp,  which 
disappeared  under  the  use  of  creosote,  externally  applied. 

"  3.  The  local  disease,  the  course  and  result  of  which 
I  present  as  the  chief  object  of  interest,  commenced  eight 
or  ten  years  since,  as  a  small  but  hard  tumor  at  the  inter- 
nal angle  of  the  right  eye.  When  first  noticed,  it  was 
about  as  large  as  a  mustard-seed,  and  not  painful.  He 
occasionally  touched  it,  and  had  some  suspicion  that  it 
might  eventually  prove  to  be  of  a  malignant  character. 
It  was  imbedded  in  the  substance  of  the  skin,  and  from 
the  first  seemed  very  slowly  to  augment  in  size.  At 
times  he  thought  he  felt  some  lancinating  pains  in  it, 
which  radiated  to  the  brow.  It  did  not,  however,  inter- 
fere with  the  functions  of  the  lachrymal  ducts,  &c.  About 
1843,  the  tumor  had  become  nearly  as  large  as  a  pea,  and 
a  tendency  to  the  formation  of  a  scab  was  observed.  He 
was  then  induced  to  try  some  local  applications,  and  fre- 
quently, until  1845,  used  Jennings's  ointment.*  This 
would  remove  the  scab,  and  display  three  small  lobes, 
from  which  exuded  a  little  purulent  fluid.  At  first,  the 
morbid  growth  seemed  lessened  by  this  and  other  milder 
*  Mackenzie  on  the  Eye. 


ON   MALIGNANT    DISEASE.  135 

applications;  but  no  permanent  effect  was  produced.  At 
times  the  discharge  ceased,  but  only  to  return  again,  and 
the  tumor  gradually  lost  its  trilobed  aspect.  It  was  at 
this  period  quite  conspicuous  to  every  bystander. 

"August,  1845,  Dr.  George  Hay  ward,  of  this  city,  re- 
moved it  with  the  scalpel.  For  a  short  time,  the  wound 
seemed  doing  well ;  but,  finally,  it  did  not  heal,  and  two 
months  afterwards  it  was  operated  on  again,  and  nitrate 
of  silver  was  applied.  Meanwhile,  however,  much  local 
pain  had  been  experienced.  It  was  deeper  seated,  less 
transitory,  and  radiated  towards  the  brow  and  cheek. 
Sometimes  it  was  severe  enough  to  awaken  him  at  night, 
and  was  worse  usually  after  long  journeys. 

"  The  applications  during  1846-7  were  chiefly  of  a  very 
similar  character,  —  cold  cream,  preparations  of  zinc,  &c. 
and  once  the  iodide  of  lead.  All  active  applications 
caused  inflammation  of  the  eye.  The  tumor  continued 
to  augment  slightly,  and  in  the  spring  of  1847  it  pre- 
sented to  my  eye  a  decidedly  malignant  appearance.  It 
was  an  ulcer,  about  the  size  of  the  top  of  the  finger,  with 
ragged,  hard,  elevated  edges  ;  and  the  irritation  from  the 
discharge  caused  the  patient  frequently  to  apply  his  hand- 
kerchief to  the  part.  At  night  it  caused  a  gluing  of  the 
lids,  and  a  discharge  at  the  side  of  the  nose.  I  certainly 
believed,  and  Dr.  Twitchell  tells  me  that  he  thought,  at 
the  time,  that  the  disease  would  gradually  augment,  and 
involve  the  eye ;  and  he  had  determined,  if  necessary,  to 
have  this  organ  extirpated.  His  general  health,  as  it  has 
been  already  stated,  continued  good  ;  but,  when  not 
actively  employed,  the  mind  was  somewhat  depressed  at 
the  prospect  before  him.  At  the  meeting  of  the  Ameri- 
can Medical  Association  in  Philadelphia,  May,  1847,  he 
consulted  several  of  the  eminent  men  whom  he  met ;  and 
I  believe,  I  may  say,  that  all  regarded  it  as  a  disease  of  a 


136  INFLUENCE    OF    DIET    ON    THE 

most  serious  nature,  although  some  thought  it  might  be 
cured  by  local  applications,  and  others  advised  a  further 
operation. 

"  Dr.  Twitchell  returned  home  discouraged,  and  he  de- 
cided to  give  up  all  use  of  medicines  internally  or  of 
external  applications,  but  to  try  a  course  of  the  most 
rigid  diet.  Starting  from  a  theory  that  malignant  dis- 
eases arise  from  the  fact  that  we  take  too  much  carbon 
into  our  systems,  he  determined  to  live  from  that  time 
upon  a  bread-and-milk  diet ;  and  if,  at  the  end  of  some 
months,  he  did  not  find  any  diminution  in  the  disease,  he 
intended  to  use  nothing  but  bread  and  water.  After  his 
return  from  Philadelphia,  he  adhered  strictly  to  the  bread 
and  milk.  He  used  three  times  daily  from  four  to  six 
ounces  of  cream,  or  the  richest  milk,  and  same  quantity 
of  either  white  or  brown  bread.  He  continues  that  diet 
still  (1849). 

"  The  results  upon  the  local  disease  were  the  following  : 
The  pains  in  the  part  were  lessened  almost  immediately* 
The  purulent  discharge  very  soon  began  to  diminish,  and 
in  two  or  three  months  it  was  evident  that  the  disease 
was  not  augmenting.  During  the  following  winter,  the 
improvement  was  more  decided.  In  the  spring  of  1848, 
being  obliged  to  ride  over  dusty  roads  to  great  distances, 
the  eye  was  more  irritated.  Nevertheless,  he  felt,  and 
his  friends  assured  him,  that  the  diseased  part  was  really 
lessening,  and  tending  towards  a  cure.  After  that  period, 
a  steady  improvement  took  place.  The  ulcerated  mass, 
which  was  so  perceptible  to  me  two  years  since,  has 
wholly  gone;  and  now  (August,  1849)  I  can  discover  no 
difference  between  the  angles  of  the  two  eyes,  save  that 
in  the  right  one  there  is  a  minute  white  spot,  about  a  line 
in  diameter,  looking  like  a  scar.  It  is  not  harder  than 
the  adjacent  parts  ;  and,  had  I  not  known  of  the  existence 


CURE    OF    MALIGNANT    DISEASE. 


137 


of  previous  disease,  I  should  not  have  noticed  even  this. 
There  is  no  discharge,  no  pain ;  and  a  perfect  cure  seems 
to  have  been  accomplished  of  a  disease  that  had  been  exist- 
ing for  about  ten  years,  in  a  patient  aged  sixty-eight  years. 

44  The  effects  of  this  rigid  diet  upon  the  constitution,  as 
a  whole,  are  interesting. 

44  Respecting  his  mental  condition,  Dr.  Twitchell  thinks 
he  has  been  much  less  irritable  than  when  he  was  omnivo- 
rous. 

44  He  had,  at  one  time,  an  attack  of  vertigo  (to  which, 
however,  he  has  been  always  liable)  ;  and,  finding  that  he 
was  growing  corpulent  under  the  diet,  he  for  a  time  took 
less  of  it. 

44  He  has  always  been  as  strong  as  when  indulging  in  a 
more  generous  diet. 

44  He  has  been  able  to  breathe  better. 

44  His  digestion  has  been  good,  but  with  a  slight  ten- 
dency to  costiveness. 

44  His  organs  of  circulation  have  been  unaffected. 

44  Renal  excretion,  for  years  a  little  disturbed,  as  is  not 
unfrequently  the  case  in  persons  of  his  age. 

44  Finally,  Dr.  Twitchell  presents,  to  my  mind,  the  pic- 
ture of  a  hale,  robust  man,  in  perfect  health,  so  far  as  one 
can  perceive,  and  but  slightly  touched  by  the  influence  of 
his  many  years  of  honorable  and  successful  labor. 

44  Reflections  upon  Dr.  TwitchelVs  Case.  —  1.  The  most 
important  topic  involved  in  the  foregoing  record  is  the 
restoration  to  health  from  what  seemed  to  be  malignant 
disease,  and  that  this  result  followed  the  strict  diet  of 
bread  and  milk  for  two  years. 

44  2.  The  cessation  of  asthmatic  difficulties,  after  they 
had  troubled  the  patient  for  twenty  years,  and  that  this 
cure  likewise  followed  the  change  of  diet,  —  from  an 
12* 


138 


CURE    OF    MALIGNANT    DISEASE. 


almost  strictly  animal  diet  to  one  quite  the  reverse,  viz. 
strictly  vegetable. 

"  3.  Some  readers  may  ask,  if  these  two  cures  are  not 
merely  examples  of  the  post  hoc ;  and  they  may  deny 
that  there  is  any  complete  evidence  of  the  propter  hoc. 
I  consent  to  the  doubt,  for  it  has  entered  my  own  mind. 
Nevertheless,  if  mere  coincidences,  they  are  pregnant 
with  important  suggestions.  I  confess  that,  in  my  own 
practice,  I  have  never  met  with  any  cases  so  significant  of 
the  power  which  diet,  simply  and  heroically  used,  has 
to  re-organize  a  man. 

"4.  Dr.  Twitchell's  case  becomes  interesting  as  an  evi- 
dence of  the  power  of  a  man  to  subject  his  body  to  strict 
rule.  In  this  epicurean  age,  it  is  quite  refreshing  to  find 
one  who  '  eats  to  live,  and  does  not  live  to  eat.'  A  wor- 
thy professional  brother,  of  this  city,  said,  when  the  case 
was  related  to  him,  '  It  might  certainly  be  a  question 
whether  life  were  desirable  under  such  a  regimen ! '  I 
honor  a  hero  wherever  I  find  him  ;  and  the  heroism  of  Dr. 
Twitchell,  in  undertaking  and  pursuing  this  course  so 
long,  merely  in  consequence  of  a  theory,*  excites  in  me 
the  greatest  delight.  In  this  sceptical,  unbelieving  era,  I 
delight  to  see  any  one  having  faith.  Whether  the  theory 
was  correct  or  not,  it  matters  little :  the  fixed  will  of  its 
follower  arouses  my  enthusiasm ;  and  this  brings  me  to 
another  topic  of  interest. f 

"  5.  The  theory  which  governed  Dr.  Twitchell  —  was  it 
correct  ?     I  confess  that  I  am  unable  to  solve  the  ques- 

*  That  Dr.  Twitchell  was  not  influenced  wholly  by  theory,  the 
additional  case,  which  I  have  presented  below,  will  prove. 

t  One  of  my  correspondents  says,  "  When  Dr.  Twitchell  had 
prescribed  for  himself  a  certain  course  of  diet,  it  was  no  unmean- 
ing remark ;  but,  with  a  deep  sense  of  religious  duty,  he  kept 
to  it  without  swerving  in  any  degree." 


CURE    OF    MALIGNANT    DISEASE.  139 

tion ;  I  merely  suggest  it.  Some,  whom  I  consider  as 
our  ablest  animal  chemists,  think  it  was  by  the  pro- 
cess of  starvation,  as  described  by  Liebig,*4  that  the  cure 
was  wrought.  It  seems  to  me  that  this  cannot  be  the 
true  explanation,  —  for  Dr.  Twitchell  has  always  been 
stout ;  and  it  will  be  remembered  that  at  one  time  he  ac- 
tually gained  flesh  under  the  diet." 

The  above  account  I  published  in  the  "  Charleston 
Journal."  It  was  subsequently  printed  in  the  "  Bos- 
ton Medical  and  Surgical  Journal ;  "  and  appended 
to  the  article  was  the  case  of  a  man,  the  result  of 
which  probably  had  much  influence  towards  in- 
ducing Dr.  Twitchell  to  undertake  his  dietetic  course. 
Dr.  W.  H.  Thayer,  in  a  letter  to  me,  says :  — 

"  I  have  obtained  from  Dr.  Twitchell  all  the  particulars 
of  the  case  of  treatment  of  osteo-sarcoma  (cancer),  which 
he  could  give  me  ;  and,  as  his  memory  is  so  accurate,  I 
suppose  he  has  not  forgotten  any  thing  of  importance  con- 
nected with  it.     You  know  the  doctor  never  takes  notes. 

"  A  man  about  forty  years  of  age  consulted  Dr.  Twit- 
chell, in  relation  to  a  tumor  on  his  scapula  (shoulder 
blade),  as  large  as  a  pint  bowl.  It  was  evidently  osteo- 
sarcoma, had  its  usual  crackling  feel,  and  resembled  very 
closely  one  in  the  same  position  which  Dr.  Twitchell  had 
seen  a  short  time  previously,  and  for  which  he  had 
removed  the  whole  upper  extremity,  even  scapula  and 
clavicle  (collar-bone).  In  that  case,  the  wound  healed ; 
but  the  man  died  a  year  or  two  afterwards,  with  carci- 
noma of  some  internal  organ.  When  the  second  case 
applied  for  advice,  Dr.  Twitchell  declined  an  operation, 
and  the  man  returned  home  to  Vermont.      Soon  after- 

t  Animal  Chemistry,  Cambridge  edition,  page  25  ;  1812. 


140  CURE    OF    MALIGNANT    DISEASE. 

wards,  he  heard  of  somebody  in  New  York  who  could 
cure  him,  and,  applying  to  this  person  for  advice,  received 
the  following :  — 

"  He  was  to  take  from  the  brook  which  ran  through  his 
native  farm  a  plant  which  grew  there  (the  adviser  did  not 
know  what  it  would  be),  and  use  a  weak  infusion  of  it  for 
his  only  drink  every  day  until  the  tumor  had  disappeared. 
His  diet,  besides  this,  was  to  consist  of  bread  alone.  This 
advice  was  strictly  followed ;  the  plant  he  used  was 
*  water  dock.'  Dr.  Twitchell  happened  to  see  the  man 
two  years  afterwards,  when  he  was  still  following  this 
course.  He  found  the  tumor  had  nearly  disappeared, 
there  being  apparently  only  a  trifling  thickening  of  the 
skin." 

These  two  histories  must  be  deeply  interesting  to 
all.  Presenting  as  they  do  the  evidence  of  the  power- 
ful influences  of  diet  upon  the  well-being  of  man, 
they  are  of  great  importance.  I  should  not  wish, 
however,  to  make  the  inference  which  some  may  be 
disposed  to  draw,  that  they  prove  the  propriety  of  an 
almost  strictly  vegetable  diet  for  all.  They  simply 
suggest  that  a  long-continued,  mild,  and  spare  diet 
may  cure,  when  other  remedies  are  of  no  avail.  I 
am  likewise  well  aware,  that,  under  the  modern  re- 
velations given  by  the  microscope  in  regard  to  the 
nature  of  tumors,  some  may  doubt  as  to  the  malignant 
character  of  Dr.  Twitchell's  disease.  Whether  it  be 
malignant  or  not,  I  am  satisfied  of  the  truth  of  the 
following  proposition :  Dr.  Twitchell  had  a  disease 
thought  to  be  of  a  malignant  character  by  the  most 
eminent  of  the  profession,  one  of  whom  had  once 
extirpated  it ;   it  had  continued  to  augment  for  eight 


DR.    TWITCHELL    AS    A    HUMORIST.  141 

years  in  spite  of  local  treatment ;  and,  finally,  under 
a  strict  diet,  it  began  soon  to  lessen  in  severity,  and, 
after  a  gradual  improvement  for  a  year,  was  wholly 
cured. 

Some  of  my  most  vivid  reminiscences  of  Dr. 
Twilchell  are  as  a  jocose  man.  Had  he  been  less 
devoted  to  temperance  than  he  was,  he  would  have 
been  distinguished  as  a  boon  companion,  and  would 
have  enjoyed  himself  over  a  foaming  mug  of  ale  as 
much  as  Burns  ever  did  over  the  punch-bowl  of 
"the  illustrious  lord  of  Laggan's  many  hills,"*  or 
during  those  hours  of  exquisite  delight  which  he 
experienced  from  his  newly-found  literary  fame  at 
Edinburgh.  Dr.  Twitchell  possessed  all  the  bois- 
terous joviality  of  Burns,  without  the  "  thoughtless 
follies"  which  "laid  low"  the  Scottish  bard. 

On  one  occasion,  he  slily  tried  to  make  himself 
merry  at  the  expense  of  myself  and  several  friends, 
who  were  taking  tea  at  his  house.  With  great 
soberness  he  informed  us  of  a  certain  fact,  which 
seemed  at  a  first  glance  very  peculiar ;  but  which, 
after  a  moment's  thought,  was  perfectly  plain.  I 
think,  however,  he  hardly  enjoyed  the  puzzle  of  the 
company  so  much  as  he  did  the  immediate  discovery, 
by  one  of  us,  of  the  attempted  cheat.  His  laugh 
was  contagious.  It  was  not  one  of  your  simple 
smiles,   a  spasmodic  twist   of  one  or  two   muscles 

*  "  Here  are  we  met,  three  merry  boys  ; 
Three  merry  boys,  I  trow,  are  wc  ; 
And  mony  a  night  we've  merry  been, 

And  mony  mac  we  hope  to  be  !  " 
Allan  Cunningham' a  Edition  of  Barns,  vol.  iv.  p.  1G9. 


142  ANECDOTE. 

about  the  face,  but  a  real,  substantial,  embodied  laugh. 
He  was  not  a  man  to  do  things  by  halves;  and  his 
laugh  was  contagious  from  its  very  universality.  A 
story  never  lost  any  thing  with  the  various  editions 
he  gave  of  it.  They  were  numberless,  and  he  en- 
tered with  equal  zest  into  their  relation  with  every 
new-comer.  The  following  is  more  than  a  "  thrice- 
told  tale ;  "  but  it  is  so  characteristic  of  him,  and  it 
will  bring  him  up  to  so  many  minds,  that  I  cannot 
forbear  telling  it,  although  it  would  be  impossible  to 
give  even  the  faintest  idea  of  his  manner  of  relating 
it.  I  have  already  alluded  to  his  humanity  towards 
animals.  It  was  especially  manifested  to  one  of  his 
old  horses,  who  had  become  almost  worn  out  in 
his  service.  It  was  so  great  that  he  would  not 
allow  the  animal  to  be  sold  or  killed.  This  creature 
had  been  a  noble  beast  in  its  youth,  and  was  pos- 
sessed of  an  unusual  degree  of  intelligence.  At  the 
time  at  which  the  following  incident  occurred,  and 
in  which  he  and  his  old  master  figured  as  the  two 
chief  characters,  he  was  shorn  of  his  early  powers. 
He  was  old  and  decrepit ;  he  did  no  work ;  but, 
day  after  day,  having  received  his  wonted  allowance 
of  grain  at  the  good  doctor's  stable,  would  wan- 
der forth  to  snuff  the  air,  and  to  browse  in  the  main 
street  of  Keene.  Everybody  knew  him,  and  his 
virtues  were  descanted  upon  by  the  villagers,  as  he 
quietly  and  with  difficulty  moved  along.  It  was  a 
fair  morning  of  a  court-day.  All  the  purlieus  of  the 
taverns  were  occupied  by  groups  of  visitors  from  the 
neighboring  towns,  who  had  come  in  to  attend  at 
the  regularly  returning  festival  of  litigation  that  we 


BUCEPHALUS.  143 

Christians  hold  in  all  our  shire  towns.  Dr.  Twit- 
chell,  as  usual,  was  out  among  the  crowd,  talking, 
joking,  arguing  with  the  bystanders.  The  old  horse, 
too,  made  his  appearance,  and  very  soon  became 
unconsciously  the  "  observed  of  all  observers," 
as  he  daintily  picked  here  and  there  a  choice  bit. 
One  of  the  numerous  parties  began  to  discuss  his 
merits;  and  it  appears  that  the  undue  warmth  of 
some  earnest  friend  caused  others  to  doubt  whether, 
after  all,  he  had  ever  been  much  of  an  animal.  It 
so  happened  that  one  of  the  backbiters  was  a  man 
upon  whom  suspicion  had  fallen  by  no  means  credit- 
able to  his  fame.  A  trial  was  at  hand,  in  which  he 
was  to  appear  as  defendant.  As  the  discussion 
grew  warmer,  Dr.  Twitchell  approached,  and  the  fol- 
lowing dialogue  took  place  :  — 

Stranger :  "  Doctor,  we  have  been  talking  about 
your  horse,  and  some  here  are  disposed  to  doubt 
about  his  good  qualities." 

"  Ah  !  "  says  the  doctor,  "  whoever  may  doubt 
his  excellent  qualities,  I  assure  you,  gentlemen, 
that  he  is  the  most  intelligent  horse  I  ever  saw. 
Why,"  continued  he,  glancing  at  the  person  above 
alluded  to,  "  he  can  tell,  at  any  time,  the  difference 
between  a  rogue  and  an  honest  man.  For  instance 
now,  if  our  friend  here  is  guilty  of  the  charge  he  is 
accused  of,  my  horse  will  recognize  it  in  his  face,  and 
will  fly  at  him  and  give  tokens  that  he  considers  him 
a  scoundrel ;  and,  if  my  horse  decides  against  him,  I 
shall  want  no  jury  to  act  upon  the  question.  What- 
ever others  may  think,  /shall  be  wholly  satisfied." 

A  long  and  loud  laugh  at  the  remark  arose  from 


144  ANECDOTE. 

the  bystanders.  "  You  may  laugh,  if  you  please," 
quietly  continued  the  doctor  ;  "  but  I  will  prove  the 

fact  to  you,  if  you  choose  to  try.     Now  Mr. , 

and    you,    Mr.  ,  may   go   up   and    speak    to 

him,  and  he  will  receive  you  pleasantly,  and  will 
take  your  caresses  with  becoming  modesty.  Every- 
body knows  you  are  honest  men.  But,  as  for  our 
friend  here,  I  tell  him  to  beware  of  going  even 
within  sight  of  the  animal,  unless  he  feels  perfectly 
innocent  in  his  own  heart."  "  Pooh  !  "  interrupted 
the  defendant,  "  it  is  all  nonsense.  Your  horse  can 
hardly  walk ;  but  I  suppose  he  is  a  surly  old  beast, 
and  will  bite  any  one."  "  By  no  means,"  replied 
the  doctor  ;  and,  again  addressing  himself  to  the 
other  bystanders,  he  said,  "  Gentlemen,  I  beg  of  you 
to  go  up,  and  see  how  kindly  he  will  treat  you ;  but 
(turning  again  to  the  man)  beware  how  you  try  it, 
unless  you  are  innocent."  Upon  this,  two  or  three 
of  the  party  walked  towards  the  old  creature,  who 
received  them  with  a  quiet  lack-lustre  eye,  and  a 
manner  which  seemed  to  indicate  that  he  felt  he  was 
receiving  nothing  more  than  his  due,  namely,  the 
respect  of  all  honorable  men.  "  Well,"  perse- 
veringly  cried  the  doctor,  "  are  not  you  going  to  try 
to  prove  your  innocence  by  the  same  test  ?  "  "I 
am  not  afraid  of  the  beast,"  ejaculated  the  man,  and 
moved  boldly  forth  towards  him.  The  doctor 
stepped  quickly  and  quietly  behind  him;  and,  as 
they  came  nearer  the  animal,  raised  his  forefinger 
far  above  the  head  of  this  victim  of  his  love  of 
joking,  and  pointed  it  towards  his  old  Bucephalus. 
What  a  change  has  come  over  the  spirit  of  the  dumb 


REMINISCENCES.  145 

beast !  He  raises  his  head,  his  eyes  glance  with 
their  ancient  fires,  his  neck  is  stretched  forth  appa- 
rently with  intense  indignation,  while,  with  dis- 
tended nostrils,  open  mouth,  and  gnashing  teeth,  he 
is  rushing  towards  the  culprit !  The  man  retreated 
precipitately;  the  doctor  dropped  his  finger,  and 
took  his  place  in  the  crowd ;  and  the  horse,  having 
apparently  driven  off  an  intruder,  quietly  resumed 
his  grazing.  "  There,"  says  the  doctor,  "  it  is  of  no 
use  to  go  to  a  jury :  I  am  satisfied.  My  horse  has 
decided  the  question."  And,  amid  uproarious  laugh- 
ter, and  much  inward  chuckling,  I  doubt  not,  on  the 
part  of  the  doctor,  he  retired,  leaving  his  opponent 
wholly  discomfited,  and  unable  to  unravel  what  to 
him  was  a  perfect  mystery.  He  did  not  learn,  until 
years  afterwards,  that  the  horse  had  been  taught  by 
Dr.  Twitchell's  students,  in  his  earlier  days,  to  run 
at  any  one  who  should  point  his  forefinger  at  him,  as 
Twitchell  did  on  this  occasion.* 

This  practical  joke  is  a  sample  of  our  friend.  No 
one  ever  enjoyed  such  a  scene  more  than  he. 

I  have  thus  glanced  at  some  of  his  characteristics, 
as  I  saw  them  in  my  various  interviews  with  him. 
And  now,  as  I  review  his  many  excellent  qualities, 
his  native  golden  intellect,  unpolished  though  it  may 
have  been  by  the  deepest  study  or  highest  art,  his 
noble  love  of  truth,  his  hatred  of  all  pretence,  his  ten- 

*  Dr.  Twitchell  was  unwilling  to  sell  this  old  and  faithful  ani- 
mal ;  so  that  at  last  the  poor  creature  became  so  decrepit,  that,  if 
he  once  lay  down,  he  could  not  arise  without  assistance.  Others 
finally  gave  orders  for  his  death,  out  of  pure  pity  for  his  infirmi- 
ties. But  his  master  is  said  to  have  wept  on  hearing  of  his  fate. 
13 


146  LAST    ILLNESS. 

derness  of  heart,  his  versatility  of  genius  as  mani- 
fested in  his  profession,  while  a  genuine  spirit  of 
mirth  shed  over  them  its  mild  and  beautiful  lustre,  — 
when  I  think  of  all  these,  I  feel  an  esteem  and  love 
for  his  great  spirit  which  no  words  can  convey,  and 
I  shall  ever  remember  the  hours  passed  with  him 
as  some  of  the  choicest  of  my  life. 

From  the  spring  of  1S42,  Dr.  Twitchell  had  been 
more  or  less  troubled  with  a  disease  not  unfrequent 
in  aged  persons  ;  and,  a  few  months  before  his  death, 
some  diabetic  symptoms  appeared.  The  appetite 
failed,  and  his  tongue  became  dry.  On  Sunday, 
May  19,  1850,  he  had  some  nausea,  which  was, 
however,  soon  relieved.  He  continued  in  bed  dur- 
ing the  day,  with  his  mind  bright  and  cheerful ;  his 
thoughts  and  conversation  running  chiefly  upon  his 
early  days. 

On  Monday  he  was  better,  and  went  down  stairs, 
though  weak  and  faint.  He  spoke  of  his  will,  and 
seemed  to  anticipate  that  his  last  hours  were  drawing 
near.  On  Monday  night,  his  friend,  who  slept  in 
the  adjacent  room,  spoke  to  him  soon  after  midnight ; 
and  he  said  that  he  had  passed  a  good  night.  Soon 
afterwards  he  arose  from  bed.  He  stretched  out  his 
arm  to  take  a  cup  from  the  table,  and  succeeded  in 
grasping  it ;  but  instantly  it  fell  and  broke.  He  was 
paralyzed  on  one  side  of  the  body,  and  became 
unable  to  speak  or  move.  He  lay  partially  reclining 
upon  the  bed  until  assistance  arrived.  His  mind 
still  seemed  perfectly  clear,  and  closely  attentive  to 
his  own  symptoms.  He  had  no  pain,  and  referred  to 
cases  similar  to  his  own,  in  which  certain  treatments 


DEATH.  147 

had  been  successful.  From  this  time  until  the  follow- 
ing Sunday,  when  he  died,  he  continued  in  the  same 
tranquil  state.  On  the  third  day,  he  asked  for  his 
purse,  and  took  from  it  some  sums  of  money,  giv- 
ing them  as  remembrances  to  the  domestics  of  his 
family.  Many  times  he  desired  to  have  some  young 
children  who  were  in  the  house  brought  near  to  his 
bed  ;  and,  on  these  occasions,  always  wished  they 
should  kiss  him.  Resting  upon  his  pure  thoughts 
and  his  good  life,  he  was  quietly  passing  away  ; 
and,  by  his  beautiful  serenity,  was  instilling  into  the 
hearts  of  the  loved  ones  around  him  lofty  views  of 
human  life  and  of  human  death.  Consistently  with 
all  his  former  course,  he  asked  for  no  vocal  prayers 
to  be  uttered  by  his  bedside.  He  felt  not  the  need  of 
any  human  mediator  between  himself  and  his  God. 
His  whole  life  had  been  one  of  prayer  and  of 
thanksgiving,  and  his  death  was  about  to  be  to  that 
life  its  crowning  grace  of  resignation  to  the  almighty 
will  of  Heaven.  On  Sunday,  his  voice  failed  him, 
and  his  power  of  swallowing  was  gone.  He  after- 
wards made  no  vain  efforts  at  conversation,  though 
capable  of  recognizing  the  children,  who  were  still 
allowed  to  climb  upon  his  bedside.  In  the  afternoon, 
that  holy  unconsciousness,  that  sweet  sleep,  which 
precedes  death,  came  over  him.  A  few  gasps,  a 
little  rattling,  and  the  great  soul  had  departed.  As 
he  had  always  desired,  he  was  preserved  from  long 
illness.  It  was  amid  the  deep  stillness  of  a  Sabbath 
evening  that  he  died. 

In  one  of  the  finest  of  Beethoven's  sonatas  is  a 
portion  entitled  a  "  Funeral  March  on  the  Death  of 


148  DEATH. 

a  Hero."  In  the  solemnity  of  its  pathos,  in  the  holy 
thoughts  it  inspires,  it  seems  no  mortal  hymn,  but, 
with  a  seraph's  power,  transports  us  far  above  the 
little  transitory  existence  of  this  earth  into  the  realms 
of  immortal  life.  There  we  see,  as  with  a  prophet's 
eye,  the  souls  of  the  noble  of  our  race,  who  have 
preceded  us  from  earliest  times,  coming  forward  to 
meet  the  brother-spirit  of  a  great  mortal,  who, 
newly  transfigured,  has  just  left  the  earth.  As  the 
music  slowly  wells  up,  we  seem  to  hear  from  afar 
the  mystic  choral  hymn,  and  even  the  measured 
movement  of  the  spirits.  All  countenances  beam 
with  the  calmness  of  truth  and  of  love.  Not  a  ray 
of  sadness  flits  across  the  brow  of  any  of  the 
heavenly  host.  The  music  ceases,  but  its  hopeful 
influences  still  cling  around  us.  Thoughts  entirely 
similar  to  these,  suggested  by  the  Miltonic  strains  of 
the  divine  composer,  arise  in  my  mind  as  I  stand  by 
the  deathbed  of  any  wise  and  good  man,  —  some  hero 
of  our  race.  He  seems  to  have  left  us  merely  to 
join  the  hosts  of  the  great  dead;  and,  on  such  an 
occasion,  sorrow  appears  to  me  sacrilege  and  im- 
piety. Need  I  say  that  such  have  been  my  most 
vivid  thoughts,  while  reviewing  the  active  and  true 
life,  with  the  tranquil  end,  of  the  strong-minded 
Twitchell  ?  May  we  not  all  reverently  hope,  that, 
even  now,  he  is  holding  communion  with  the  glorious 
ones  who  in  past  ages  have  gone  down  like  him 
honored  to  their  graves  ! 


149 


CHAPTER    IX. 


Conclusion.  —  Outlines  of  Dr.  TwitchelTs  Character. 


Dr.  Twitchell  was  no  shadow  of  another,  nor  the 
exponent  of  any  set  of  opinions,  but  a  living  speci- 
men of  what  a  great,  self-relying  mortal  may  become. 
In  summing  up  his  character,  I  recognize  that  of  a 
man  possessed  of  infinite  humor,  of  a  strong,  vigor- 
ous intellect,  and  a  reverence  for  truth  in  speech  and 
act,  which,  while  it  made  him  always  ready  to  ac- 
knowledge his  own  errors,  likewise  aroused  his  in- 
dignation against  hypocrisy  and  pretence  wherever 
seen.  Joined  to  these  traits,  and  in  beautiful  har- 
mony with  them,  was  his  warm  heart.  Ardent  in 
his  attachment  to  friends  through  every  stage  of  life, 
and  wisely  benevolent  to  those  less  closely  united  to 
him,  he  went  about  daily  doing  good.  "  Like  the 
sun,"  says  one  of  my  correspondents,  "  he  poured 
forth  of  his  abundance,  and  sought  no  return." 
"  His  great  nature,"  says  another,  "  had  all  the  ele- 
ments of  justice,  truth,  and  integrity,  love  and  ten- 
derness, though  perhaps  not  in  all  respects  refined, 
compounded,  and  harmonized,  so  as  to  realize  the 

13* 


1.50 


CHARACTER. 


perfect  man,  as  in  how  very  few  even  of  the  most 
sincere  Christians  they  are.  But,  in  the  robust  vigor 
and  straightforwardness  of  his  life,  and  in  the  melt- 
ing sympathy  of  his  heart  in  sickness  and  trial ;  in 
his  tender  domestic  affections,  and  in  his  early  and 
long-tried  efforts  in  the  cause  of  temperance,  none 
could  fail  to  see  the  essential  good  man,  by  whatever 
name  called." 

In  confirmation  of  my  views  of  Dr.  Twitchell's 
intellectual  power,  I  will  quote  from  the  opinion  of 
one  who  perhaps  is  as  good  a  judge  of  purely  intel- 
lectual greatness  as  this  or  any  other  country  can 
present.  Daniel  Webster,  in  the  letter  already 
quoted,*  writes  thus  :  "  Dr.  Twitchell  and  myself 
were  members  of  Dartmouth  College  at  the  same 
time,  and  I  have  known  much  of  him  since,  as  in 
the  earlier  part  of  my  professional  practice  my  duties 
often  called  me  to  the  place  of  his  residence.  From 
first  to  last,  I  have  entertained  for  him  the  highest 
respect  and  most  cordial  esteem.  His  mind  was 
remarkable  for  strength,  vigor,  and  originality,  and 
much  given  to  deep  and  profound  thinking ; "  and 
again  he  writes,  "  I  should  have  looked  to  Dr.  Twit- 
chell, as  soon  as  to  almost  any  other  man,  for  what- 
ever could  be  accomplished  by  intellectual  energy 
and  application." 

Standing  pre-eminent  among  his  fellows  of  the 
medical  profession,  no  one  can  accuse  him  of  an 
illiberal  or  unjust  course.  Autocrat  in  surgery  for 
all  the  country  round,  he  was,  on  all  occasions,  very 
friendly  to  those  younger  than  himself.  He  helped 
*  Page  16. 


CHARACTER.  151 

them  onwards,  and  they  all  loved  him  as  a  father. 
Cordial,  though  commanding,  with  those  who  were 
his  equals  in  years,  he  gained  their  respect  for  his 
perfect  fairness.  Without  formality  or  pretence, 
his  professional  skill  seemed  to  the  uninitiated  like 
intuition.  He  said  little,  but  was  prompt  in  his  de- 
cisions, from  which  he  never  swerved  ;  he  was  ener- 
getic and  thorough  in  the  performance  of  what  he 
determined  to  do.  Never  appalled  by  unforeseen 
circumstances,  he  always  had  an  expedient  ready 
for  the  occasion.  Hence  he  has  been  called  "  a  man 
of  expedients."  It  has  been  well  said  that  he  would 
have  made  a  good  general,  had  a  military  life  been 
his  choice,  instead  of  the  more  quiet  paths  of  profes- 
sional duties  ;  for  "  he  was  secret  in  counsel,  prompt 
and  overwhelming  in  execution."  He  was  unable, 
from  his  excessive  bodily  toil  and  his  long  excur- 
sions, to  keep  up  with  the  medical  literature  of  the 
day.  But,  by  means  of  his  keen  perceptive  facul- 
ties and  power  of  concentrating  his  whole  mind 
rapidly  on  a  subject,  he  contrived  to  get  at  the 
essentials  of  every  valuable  improvement ;  and,  at 
times,  the  quickness  of  his  apprehension  and  the  vigor 
of  his  judgment,  combined  with  his  extraordinary 
memory  and  practical  common  sense,  supplied  the 
defects  in  his  knowledge  of  what  had  been  done  by 
others  in  the  particular  subject  on  which  he  hap- 
pened to  be  engaged.  As  an  operator,  he  was  bold, 
yet  cautious ;  and  he  never  forgot  that  mere  manual 
dexterity  is  but  a  small  element  in  the  requisites  for 
a  great  surgeon. 

He  has  left  no  permanent  monument  of  his  fame 


152  CHARACTER. 

in  the  form  of  a  written  book.  His  memory  will  be 
kept  green  by  all  his  contemporaries ;  but  their  chil- 
dren's children  will  know  of  him  only  by  the  tradi- 
tions which  the  people  will  hand  down  of  his  powers 
as  the  great  surgeon  and  well-beloved  physician  of 
the  North.  How  much  do  I  regret  that  he  had  no 
Boswell  by  his  side  during  life ;  no  one  to  report  his 
"  Table  Talk  "  !  A  few  transitory  papers  alone 
remain  to  mark  the  labors  of  his  life ;  but  the  seeds 
that  he  has  planted  in  many  minds  will  arise,  and, 
all-unconscious  of  their  origin,  bring  forth  fruit. 
For  us  his  light  is  now  for  ever  set.  The  twilight  of 
sweet  memories  will,  however,  long  gild  his  grave ; 
and  the  secret  moaning  of  thousands  of  human  hearts 
will  be  his  appropriate  requiem. 


APPENDIX. 


APPENDIX    A. 


The  following  is  the  translation  of  the  Greek  oration  referred  to 
on  page  24  of  the  Memoir.  It  is  the  unfinished  production  of 
a  youth  not  accustomed  to  the  egression  of  his  thoughts  in  any 
written  form.  It  is  printed  because  it  illustrates  in  some  degree 
his  philosophical  turn  of  mind. 


THE  INFLUENCE  OE  NATURAL  OBJECTS  UPON  THE 
MIND. 

Happy  the  man  who  follows  the  lessons  which  nature 
continually  dictates !  "What  a  striking  similarity  do  we 
behold  between  the  natural  face  of  a  country  and  the 
mental  abilities  of  its  inhabitants !  Whence  it  appears  that 
the  genius  and  understanding  of  men  are  greatly  affected 
by  natural  objects.  If  we  look  at  the  Arabs,  surrounded 
by  scorching  sands  and  fanned  by  poisonous  winds,  what 
are  their  abilities,  and  what  their  manners  ?  Surely  they 
are  a  complete  emblem  of  the  country  which  they  inhabit. 
The  barren  sand  represents  their  minds,  and  the  rugged 
mountains  their  manners.  And  thus,  wherever  nature 
has  been  parsimonious  of  her  gifts  to  the  earth,  there  we 
observe  a  deficiency  in  the  minds  of  the  inhabitants. 

But  why  need  we  thus  labor  to  show  this  correspond- 
ence ?  We  may  affirm,  that,  from  natural  objects,  we  derive 
all  our  knowledge,  and  consequently  all  our  happiness. 


156  *  APPENDIX    A. 

By  the  medium  of  our  senses,  they  stimulate  our  minds 
to  action,  which  otherwise  would  be  entirely  dormant. 
They  lay  the  sole  foundation  of  all  morality,  leading  us 
to  contemplate  their  Author ;  and  they  are  the  source  of 
all  our  enjoyments. 

On  whatever  part  of  creation  we  turn  our  eyes,  we 
everywhere  find  something  which  interests  either  our 
senses,  our  imagination,  or  our  reason.  Our  love  of 
variety  is  constantly  excited,  and  constantly  gratified. 
There  is  no  part  of  the  day  which  does  not  afford  us  plea- 
sures both  for  our  senses  and  for  our  minds.  While  the 
sun  illuminates  our  horizon,  the  plants,  the  animals,  and 
a  thousand  other  agreeable  objects,  strike  our  eyes;  and, 
when  night  spreads  its  veil,  the  majesty  of  the  sky  trans- 
ports and  charms  us.  On  every  side,  nature  labors  to 
surprise  us  with  new  pleasures.  Even  the  smallest  worm, 
a  grain  of  sand,  presents  us  with  objects  of  admiration, 
pleasure,  and  improvement. 

Those  pleasures  which  are  only  the  work  of  our  own  ima- 
gination are  transitory  and  vanish  like  a  dream,  the  charms 
and  illusions  of  which  are  lost  on  the  moment  of  waking. 
But  the  pleasures  which  we  derive  from  the  contemplation 
of  the  works  of  nature  are  solid  and  lasting,  because  they 
open  to  us  an  inexhaustible  source  of  new  delights.  The 
God  of  nature  seems  to  have  had  in  view  the  happiness 
of  his  creature  man,  in  the  erection  of  all  his  works.  Be- 
hold !  he  has  clothed  the  earth  with  a  lively  green  color, 
which  is  the  most  mild,  and  pleasing  to  the  sight ;  he  has 
accommodated  us  with  an  atmosphere  fit  for  the  respiration 
of  animals,  and  continually  supplies  its  expenditures  by 
exhalations  from  vegetables.  As  the  contemplation  of 
these  objects  promotes  civilization,  and  civilization  makes 
mankind  capable  of  receiving  more  pleasure  from  the 
beauties  of  nature ;  as  we  advance  in  the  path  of  science, 


GREEK    ORATION.  157 

we  are  enabled  to  observe  a  greater  number  of  connec- 
tions, dependencies,  and  relations  among  the  objects  of 
nature,  the  beauty  and  harmony  of  which  impress  our 
minds  with  agreeable  ideas,  and  give  us  a  more  just  con- 
ception of  their  Author  than  we  otherwise  should  have. 

How  stupid  must  that  man  be  who  does  not  receive 
lessons  of  morality  from  the  display  of  such  wisdom, 
power,  and  goodness  as  is  manifested  in  all  the  work  of 
creation  !  They  naturally  lead  us  to  inquire,  To  whom  do 
we  owe  these  numerous  and  varied  gifts  of  nature  ?  Who 
is  he  who  provides  for  our  wants  and  pleasures  with 
such  goodness  and  munificence  ?  Let  us  ask  it  of  all 
nature !  The  hills  and  valleys  will  tell  us ;  the  earth 
points  him  to  our  sight ;  the  sky  is  a  mirror  in  which  we 
may  behold  him ;  the  storms  and  tempests  proclaim  him  ; 
the  voice  of  thunder,  the  rainbow,  and  snow  declare  his 
wisdom  and  goodness !  And  all  the  numerous  host  of 
animals,  which  are  the  inhabitants  of  the  air,  the  earth, 
and  the  sea,  declare  the  glory  of  the  Almighty,  and  pro- 
claim his  existence.  Those  rich  lands  where  our  flocks 
graze ;  those  forests  which  afford  us  shade  and  fuel,  and 
a  vast  multitude  of  divine  gifts,  invite  us  to  grateful  joy. 
It  is  thus  that  nature  becomes  an  admirable  lesson  for  the 
heart.  If  we  listen  to  it,  we  shall  know  the  true  wisdom 
which  leads  to  happiness.  We  shall  find  that  there  is  no 
satisfaction  more  sincere  or  more  lasting,  or  more  con- 
formable to  human  nature,  than  the  pleasures  which  are 
afforded  by  the  contemplation  of  the  works  of  nature. 


14 


158 


APPENDIX    B. 


LIGATURE  OF  THE  COMMON  CAROTID  ARTERY, 

AS  PERFORMED  BY  DR  TWITCILELL  IN  1807. 

During  a  mock-fight,  at  a  regimental  review  in  Temple, 
in  New  Hampshire,  on  the  8th  October,  1807,  John  Tag- 
gart,  of  Sharon,  a  cavalry  soldier,  set.  twenty  years, 
received  a  wound  (supposed  to  have  been  caused  by  the 
wadding  and  burning  powder  from  a  pistol  discharged 
near  him)  on  the  right  side  of  the  neck  and  face,  extend- 
ing from  behind  obliquely  forward  into  the  mouth.*  He 
was  immediately  conveyed  to  a  public-house,  where,  at 
the  request  of  Dr.  Crombie,  then  surgeon  to  the  regi- 
ment, I  assisted  in  the  examination  and  dressing  of  the 
wound,  and  subsequently  took  charge  of  the  case.  We 
found  the  whole  of  the  right  side  of  the  head,  face,  and 
neck,  very  much  burned ;  and  a  large  wound  penetrating 
the  pharynx  and  mouth,  by  which  were  destroyed,  or 
greatly  lacerated,  nearly  the  whole  of  the  parotid  gland, 
the  temporal,  masseter,  and  pterygoid  muscles ;  and  also 
parts  of  the  muscles  on  the  anterior  part  of  the  neck 
between  the  inferior  maxillary  bone  and  the  os  hyoides. 
The  angle,  ramus  and  coronoid  process  of  the  inferior 
maxillary  bone,  and  the  pterygoid  process  of  the  sphenoid 

*  The  treatment  of  this  case  is  discussed  in  the  Memoir.  See 
pages  63—73. 


LIGATURE    OF    THE    CAROTID    ARTERY.  159 

bone,  were  shattered;  and  that  part  of  the  superior 
maxillary  bone  which  covers  the  antrum  Highmorianum 
was  so  broken,  that  the  finger  could  be  readily  introduced 
into  the  cavity ;  the  right  side  of  the  tongue  was  also 
somewhat  lacerated.  Although  the  external  carotid 
artery  and  its  branches  had  been  divided,  yet,  at  the  time 
of  the  injury,  the  hemorrhage  was  not  copious.  All  the 
fragments  of  bone  which  were  so  situated  that  they  could 
be  extracted  without  much  difficulty  were  removed ;  sim- 
ple dressings  applied  to  the  wound ;  the  patient  was  put 
to  bed,  and  an  anodyne  draught  administered. 

Oct.  9.  —  The  patient  had  rested  but  little ;  there  was 
a  good  deal  of  arterial  excitement ;  and  so  much  inflam- 
mation and  swelling  of  the  throat  and  fauces,  that  he  was 
unable  to  swallow  or  to  articulate  intelligibly.  His 
respiration  was  somewhat  impeded ;  his  face  very  much 
swollen;  and  he  had  great  pain  in  the  head.  I  directed 
V.  S.  §xx. ;  an  evaporating  lotion  to  be  applied  to  the 
head  and  face ;  and  a  cathartic  enema  to  be  adminis- 
tered, which  procured  two  or  three  dejections.  These 
remedies  appeared  to  give  some  relief  for  a  few  hours  ; 
but,  in  the  evening,  the  excitement  and  pain  increased. 
Ten  or  twelve  ounces  more  of  blood  were  taken  ;  the 
lotion  to  the  head  and  face  was  directed  to  be  continued  ; 
and  an  emollient  poultice  to  be  applied  to  the  wound. 

Oct.  10.  —  The  patient  had  slept  some  during  the 
night;  the  pain  and  swelling  were  diminished;  and,  with 
much  difficulty,  he  swallowed  a  little  cold  water,  though 
a  part  of  it  escaped  from  the  wound  in  the  attempt.  The 
local  applications  were  directed  to  be  continued  ;  a  tea- 
spoonful  of  a  solution  of  borate  of  soda  to  be  put  into 
the  mouth  every  half-hour ;  and  a  little  gruel  to  be  given 
if  he  could  swallow  it.  In  the  afternoon  he  was  removed 
to  his  father's  house  in   Sharon,  a  distance  of  eight  or 


160  APPENDIX  B. 

nine  miles,  without  any  unfavorable  symptom  being  de- 
veloped. A  cathartic  of  magnes.  sulph.  was  ordered  to 
be  taken  as  soon  as  practicable. 

Oct.  12.  —  The  inflammation,  pain,  and  swelling  were 
much  diminished.  Pulse  70 — 80,  soft.  He  could  arti- 
culate more  distinctly,  and  the  deglutition  was  improved ; 
though,  in  the  attempt  to  swallow  liquids,  a  part  still 
escaped  through  the  wound.  Suppuration  had  com- 
menced ;  and  the  dead  parts  were  beginning  to  separate. 
The  posterior  upper  tooth  of  the  side  affected  appeared 
in  the  wound,  and  was  removed.  The  magn.  sulph.  had 
procured  three  or  four  dejections.  The  emollient  poul- 
tices were  continued  ;  and  he  got  a  little  broth. 

Oct.  14.  —  Suppuration  copious;  some  portions  of  the 
dead  parts  had  become  detached,  and  were  removed ;  and 
some  fragments  of  bone  came  away. 

Oct.  16.  —  Since  the  last  visit,  the  disorganized  parts 
had  very  much  separated ;  and  the  coronoid  process,  angle 
and  ramus  of  the  inferior  maxillary  bone,  as  far  as  the 
posterior  molar  tooth,  had  now  been  removed.  The 
patient  could  sleep  quietly,  and  could  take  as  much  food 
as  was  necessary.  I  discontinued  the  poultice,  and 
directed  simple  cerate  spread  on  pledgets  of  lint  to  be 
applied. 

Oct.  18.  —  (Ten  days  after  injuryi)  The  wound  had 
now  become  cleared  of  all  dead  portions  of  muscle  and 
cellular  membrane,  and  presented  a  large  circular  aper- 
ture from  two  to  three  inches  in  diameter ;  at  the  bottom 
of  which  might  be  distinctly  seen  the  internal  carotid 
artery  denuded  from  near  the  bifurcation  of  the  common 
trunk,  to  where  it  forms  a  curve  to  enter  the  canal  in  the 
petrous  portion  of  the  temporal  bone.  Directly  upon  this 
curve  of  the  artery  might  be  seen  a  dark  speck,  of  a  line 
or  two  in  diameter,  which  seemed  to  be  a  dead  portion  of 


LIGATURE    OF    THE    CAROTID    ARTERY.  161 

cellular  membrane  adhering  to  the  coats  of  the  vessel.  I 
carefully  touched  it  with  a  probe;  but,  finding  that  it 
adhered,  I  desisted  from  the  attempt  to  remove  it,  and 
expressed  to  the  patient  and  his  friends  my  fears  of  a  dan- 
gerous if  not  fatal  hemorrhage  when  that  should  separate. 
I  applied  the  usual  dressings,  left  the  room,  and  was 
about  leaving  the  house,  when  some  one  of  the  family 
cried  out  that  he  was  bleeding.  I  hastened  back  to  his 
room,  and  found  him  deluged  with  blood.  The  dressings 
were  immediately  removed,  and  the  blood  jetted  forcibly, 
in  a  large  stream,  to  the  distance  of  three  or  four  feet. 
"With  the  thumb  of  my  left  hand,  I  instantly  compressed 
the  artery  against  the  base  of  the  skull,  and  thus  ef- 
fectually controlled  the  hemorrhage.  The  patient  had 
fainted ;  and  fifteen  or  twenty  minutes  had  elapsed  before 
he  was  so  much  revived  that  I  dared  to  make  any  attempt 
to  secure  the  artery.  Then,  still  keeping  the  thumb 
firmly  pressed  on  the  orifice,  I  proceeded  to  clear  the 
wound  from  blood ;  and,  having  done  this,  I  made  an  in- 
cision, with  a  scalpel,  downward,  along  the  course  of  the 
artery,  to  more  than  an  inch  below  the  point  where 
the  external  branch  was  given  off;  which,  as  stated 
above,  had  been  destroyed  at  the  time  of  the  injury. 
Having  but  one  hand  at  liberty,  I  depended  upon  the 
mother  of  the  patient  to  separate  the  sides  of  the  wound  ; 
which  she  did,  partly  with  a  hook  and  occasionally  with 
her  fingers.  At  length,  partly  by  careful  dissection  and 
partly  by  using  my  fingers  and  the  handle  of  the  scalpel, 
I  succeeded  in  separating  the  artery  from  its  attachments  ; 
and,  passing  my  finger  under  it,  I  raised  it  up  sufficiently 
for  my  assistant  to  pass  a  ligature  round  it.  She  tied  it 
with  a  surgeon's  knot,  as  I  directed,  at  about  half  an  inch 
below  the  bifurcation. 
14* 


162  APPENDIX    B. 

I  removed  my  thumb  and  sponged  away  the  blood,  not 
doubting  that  the  hemorrhage  was  effectually  controlled. 
But,  to  my  surprise  and  disappointment,  the  blood  imme- 
diately began  to  ooze  from  the  rupture  in  the  artery  ;  and 
in  less  than  ten  minutes  it  flowed  with  a  pulsating  jet.  I 
compressed  it  again  with  my  thumb,  and  began  to  de- 
spair of  saving  my  patient.  What  further  could  I  do  r 
It  was  impossible  to  apply  a  ligature  above  the  orifice : 
compression,  then,  was  the  only  alternative.  How  was 
that  to  be  effected  ?  Should  some  one  sit  by  the  patient, 
and  compress  the  artery  constantly  with  the  fingers  till 
adhesion  should  take  place  ?  Possibly  that  might  have 
been  done ;  but  I  resolved  to  make  another  attempt  first. 
Raising  my  thumb,  I  placed  a  small  piece  of  dry  sponge 
directly  over  the  orifice  in  the  artery ;  and,  renewing  the 
compression  till  a  little  larger  piece  of  sponge  could  be 
prepared,  I  placed  that  upon  the  first ;  and  so  went  on, 
pressing  the  gradually  enlarged  pieces  obliquely  upwards 
and  backwards  against  the  base  of  the  skull,  till  I  had 
filled  the  wound  with  a  firm  cone  of  sponge,  the  base  of 
which  projected  two  or  three  inches  externally.  Then 
I  applied  a  linen  roller  in  such  a  manner  as  to  press 
firmly  upon  the  sponge;  passing  it,  in  repeated  turns, 
over  the  head,  face,  and  neck.  I  directed  that  the  patient 
should  be  placed  in  bed,  with  his  head  moderately  raised, 
and  that  he  should  be  kept  as  quiet  as  possible ;  and,  as 
his  pulse  was  very  feeble,  he  having  lost  at  that  time 
between  three  and  four  pounds  of  blood  by  estimation, 
he  was  allowed  a  little  wine  and  water,  and  occasionally 
some  broth.  We  carefully  watched  him  through  the 
night ;  but  no  bleeding  occurred,  and  he  complained  of 
but  little  pain. 

Oct.    20.  —  (Forty-eight   hours   after    the    operation.) 
There  had  been  no  hemorrhage  ;  and  there  was  but  little 


LIGATURE    OF    THE    CAROTID   ARTERY.  163 

excitement.  Pulse  95  —  regular.  I  directed  the  patient 
to  take  gruel  and  broth  ;  and  a  little  wine  and  water,  if 
faint.     This  course  was  pursued  till 

Oct.  24,  —  when  the  bandage  was  removed  and  a  fresh 
one  applied,  without  disturbing  the  sponge. 

Oct.  26.  —  The  fetor  arising  from  the  accumulation  of 
matter  in  the  sponge  had  become  so  offensive  as  to  nau- 
seate the  patient.  I  carefully  removed  several  of  the 
external  pieces  of  sponge,  washed  the  wound  with  a  weak 
solution  of  potass,  carb.,  substituted  lint  in  the  place  of 
the  sponge  which  had  been  removed,  and  applied  the 
bandage  as  before. 

Oct.  28.  — All  the  sponge  was  removed,  except  a  small 
piece  directly  on  the  artery ;  the  wound  was  washed  with 
a  weak  alkaline  lotion  ;  and  pledgets  of  lint,  spread  with 
simple  cerate,  were  applied. 

Oct.  30.  —  The  ligature  on  the  carotid  came  away,  and 
the  wound  was  rapidly  filling  up  with  granulations. 

Nov.  1.  —  The  remaining  piece  of  sponge  was  removed. 
The  patient  attempted,  for  the  first  time  since  the  injury, 
to  masticate  his  food;  but  the  under  jaw  was  drawn  so 
much  to  the  left  that  the  teeth  would  not  meet.  To 
remedy  this  inconvenience,  I  caused  an  ingenious  black- 
smith in  the  neighborhood  to  make  an  instrument  some- 
thing like  Hull's  truss ;  one  end  of  this  being  fitted  to 
the  top  of  the  head,  it  was  brought  down,  on  the  right 
side,  under  the  chin ;  and  the  pad  on  the  other  end  was 
made  to  press  on  the  left  side  of  the  inferior  maxillary 
bone.  He  wore  this  instrument  most  of  the  time  during 
the  remainder  of  the  treatment;  and  it  effectually 
answered  the  purpose. 

Nov.  11.  —  The  patient  had  very  much  improved. 
Several  pieces  of  bone  and  a  tooth  had  passed  out  from 
the   wound,  which   was  rapidly  cicatrizing.     There  was 


164  APPENDIX    B. 

but  little  discharge  of  matter ;  he  was  able  to  move  his 
lower  jaw,  and  to  masticate  solid  food  with  ease. 

Dec.  30.  —  Some  small  fragments  of  bone,  and  a  tooth 
from  the  upper  jaw,  had  been  cast  off.  The  wound  was 
completely  cicatrized,  and  the  parts  consolidated.  There 
was,  however,  some  little  deformity,  in  consequence  of  the 
depression  on  the  right  side  of  the  face. 

This  case  seemed  to  me  at  the  time  highly  important 
and  valuable  ;  since  it  established  surgical  facts,  which,  as 
far  as  my  knowledge  extended,  had  not  till  then  been 
known.  The  question  of  the  practicability  of  the  safe 
application  of  the  ligature  to  the  common  carotid  artery 
was,  in  my  opinion,  now  solved.  I  had  entertained  that 
opinion  for  some  time  before ;  having  repeatedly  tied  the 
vessels  in  dogs,  and  in  one  instance  in  a  horse,  without 
causing  them  much  inconvenience  ;  but,  at  that  time,  I 
had  seen  no  account  of  its  having  been  attempted  on  the 
human  subject. 

Sir  Astley  Cooper's  claim  of  priority  in  the  successful 
application  of  the  ligature  to  the  common  carotid  artery 
has  been  generally  acknowledged.  He  performed  the 
operation  in  June,  1808;  eight  months  after  the  above 
operation.  Sir  Astley's  case  was  undoubtedly  the  first 
published ;  but  it  appears  from  some  recent  publications, 
that  Mr.  Fleming,  of  the  British  navy,  tied  the  vessel  on 
the  17th  October,  1803,  for  a  servant  on  board  ship  who 
had  attempted  to  commit  suicide.  The  patient  recovered. 
Mr.  Fleming  died  abroad  ;  and  the  case  was  first  pub- 
lished by  his  assistant-surgeon,  Dr.  Coley,  in  January, 
1817. 

Of  late,  this  operation  has  become  very  frequent,  not 
to  say  fashionable,  in  this  country  at  least ;  and  in  some 
cases,  accounts  of  which  have  been  published,  I  should 
think  it   had   been  performed   unnecessarily.     The  case 


LIGATURE    OF    THE    CAROTID    ARTERY.  165 

related  above,  in  my  opinion,  clearly  demonstrates  the  in- 
utility and  consequent  impropriety  of  tying  the  carotid 
artery  for  the  purpose  of  preventing  the  growth  of  tumors 
about  the  head  and  neck,  or  as  a  step  preparatory  to  the 
removal  of  such  tumors  by  the  knife.  Although  the  com- 
mon carotid  had  been  tied,  but  a  few  moments  only 
elapsed  before  the  hemorrhage  from  above  was  so  profuse 
as  to  require  immediate  and  continued  compression.  If  the 
circulation  is  so  soon  restored  by  anastomozing  branches, 
of  what  use  can  the  ligature  be  under  such  circumstances, 
or  what  prospect  can  it  offer  of  preventing  the  growth  of 
such  tumors  ?  Reason,  and  the  experience  of  all  practical 
surgeons,  concur  to  show,  that,  whenever  an  arterial  trunk 
is  tied,  or  in  any  way  obstructed,  the  circulation  is 
promptly  restored  by  anastomosis ;  else  mortification  would 
be  the  consequence. 


166 


APPENDIX    C. 


CASES     OF    MORBID    ANATOMY. 


Case  I. 

April  18,  1808. 
Urinary  Organs. 

J.  F.  aged  eighty-two,  had  for  nearly  twenty  years  past 
been  attended  with  pain  in  the  region  of  his  kidneys,  with 
painful  micturition.  His  urine  was  very  often  turbid 
■with  blood,  and  sometimes  the  discharge  from  the  bladder 
would  for  several  days  appear  to  be  entirely  blood,  which 
was  frequently  voided  in  a  coagulated  state.  He  had 
resorted  to  various  medicines  for  the  relief  of  the  above 
symptoms ;  but  he  scarcely  received  a  temporary  benefit 
from  any.  After  death,  permission  was  obtained  to  ex- 
amine the  viscera  of  the  abdomen.  The  liver,  spleen, 
pancreas,  stomach,  and  intestines  were  severally  attended 
to,  but  did  not  appear  to  be  much  diseased.  The  left 
kidney  was  next  examined.  The  membrana  adiposa  was 
very  much  thickened  and  indurated  ;  upon  the  removal  of 
which,  the  proper  coat  of  the  kidney  was  discovered  like- 
wise to  be  in  an  indurated  state.  The  body  of  the  kidney 
was  rather  diminished  in  size,  but  completely  filled  with 
pus.  The  ureter  and  pelvis  were  enlarged  to  nearly  three 
times  their  natural  size. 


URINARY    ORGANS.  167 

Upon  examining  the  right  kidney,  the  membrana  adi- 
posa  did  not  appear  so  much  diseased  as  upon  the  other 
side,  but  was  somewhat  indurated  upon  its  superior  part. 
The  substance  of  the  kidney  itself  on  this  side  had  fallen 
a  prey  to  disease,  excepting  a  small  portion  of  the  cortical 
part  on  the  convex  side,  which  was  the  only  remaining 
portion  to  be  found.  Attached  to  this  part  was  a  sack, 
which  was  judged  to  contain  about  half  a  pint  of  a  fluid 
which  had  a  resemblance  to  water  turbid  with  blood. 
From  this  bladder  issued  the  ureter,  which  was  about 
three-fourths  of  an  inch  in  diameter.  Upon  opening  the 
before-mentioned  bladder  or  sack,  it  appeared  to  be  an 
enlargement  of  the  pelvis  and  infundibula  of  the  kidney. 
Some  of  the  infundibula  were  still  to  be  discovered 
attached  to  the  remaining  portion  of  the  kidney,  but  so 
enlarged  that  some  of  them  were  an  inch  in  diameter. 

The  urinary  bladder  was  very  much  contracted,  and 
filled  with  a  substance  resembling  cheese-curd,  or  what  is 
frequently  observed  in  scrofulous  glands.  The  muscular 
coat  of  the  bladder  was  very  much  thickened. 

Remarks.  — The  above  appearances  lead  us  to  conclude, 
that  the  disease  began  in  the  first  place  in  the  urinary 
bladder,  producing  an  obstruction  to  the  discharge  of 
urine  from  the  right  ureter,  which  became  distended  and 
very  much  enlarged  ;  the  distention  and  enlargement  ex- 
tending to  the  pelvis  of  the  kidney.  As  this  process 
advanced,  the  substance  of  the  kidney  became  more  and 
more  compressed  till  it  was  in  a  great  measure  lost ;  being 
converted  into  a  sack  containing  cells,  which  were  the  en- 
largement of  the  infundibula. 

It  has  been  remarked  by  writers,  that  the  kidney  will 
secrete  urine  when  the  natural  structure  is  almost  entirely 
lost.  After  this  process  had  advanced  considerably,  it  is 
probable  that  the  left  ureter  became  obstructed,  that  the 


163  APPENDIX    C. 

pelvis  began  to  enlarge;  but  the  pressure  upon  the  kid- 
ney produced  inflammation  and  suppuration.  What 
should  produce  the  first  obstruction  to  the  free  passage  of 
the  urine  into  the  bladder,  it  is  difficult  to  tell.  May  it 
not  have  arisen  from  a  scrofulous  affection  of  the  blad- 
der? 

Case  II. 
Hydrocephalus  Internus. 

In  the  month  of  December,  1807,  a  child  of  T.  T.  aged 
three  months,  was  attacked  with  the  hooping-cough. 
After  a  violent  course  of  the  disease,  she  appeared  to 
recover  so  far,  that  the  parents  considered  her  well,  ex- 
cepting they  observed  "  something  singular,"  as  they 
expressed  it,  in  the  appearance  of  her  eyes.  She  fre- 
quently was  observed  to  apply  her  hand  to  her  head,  and 
to  cry  in  a  moaning  voice. 

The  first  of  May,  1808,  she  was  troubled  with  diarrhoea, 
for  which  magnesia,  &c.  were  prescribed,  and  appeared 
to  check  it. 

May  5.  —  The  child  showed  evident  symptoms  of  the 
hydrocephalus  internus.  The  fontanelle  became  very  pro- 
minent and  tense.  An  emetic  was  prescribed.  6th.  The 
emetic  has  operated  very  powerfully,  without  mitigating 
the  symptoms.  Calomel  and  opium  in  small  doses  were 
now  administered.  7th.  Symptoms  become  violent. 
There  is  a  strabismus  of  left  eye.  Medicine  as  yesterday, 
with  addition  of  a  cath.  with  calom.  8th.  Much  as  yes- 
terday ;  the  skin  has  become  very  dry,  especially  in  the 
palms  of  the  hand  ;  some  sweating  about  the  head. 
Tinct.  of  canth.  Avas  applied  externally,  particularly  to 
the  head  and  neck  and  spine.  9.  She  has  had  convul- 
sions,  and   the  urine    is    diminished    in    quantity.     She 


HYDROCEPHALUS  INTERNUS.  169 

shrieks  and  cries  upon  being  moved.  A  blister  was  ap- 
plied to  the  back  of  the  neck,  and  the  tinct.  digitalis 
given  internally.  10.  The  right  side  has  become  para- 
lytic, and  the  left  is  frequently  convulsed.  There  is  a 
strabismus  now  upon  both  eyes.  The  tumor  at  the  fon- 
tanelle  continues  to  increase  ;  she  voids  urine  pretty  freely, 
and  has  had  as  many  as  two  or  three  stools  in  twenty- 
four  hours.  A  blister  is  now  applied  to  the  fontanelle. 
11.  Symptoms  and  medicines  as  yesterday.  12.  The 
blister  at  the  fontanelle  does  not  discharge  much ;  it  is 
repeated.  The  patient  has  had  frequent  convulsions ;  she 
now  lies  stupid.  The  left  arm  and  legs  are  in  a  con- 
vulsed state,  the  hand  is  clenched,  and  the  arm  raised 
towards  the  head.  The  leg  is  drawn  up  to  nearly  a  right 
angle  with  the  knee.  The  right  side  continues  in  a  para- 
lytic state  ;  the  mouth  drawn  to  the  right  side.  14.  Con- 
tinues to  have  frequent  convulsions,  with  frequent  shriek- 
ings ;  opiates  have  been  continued  through  whole  dis- 
ease, and  appear  to  mitigate  the  convulsions.  When  she 
winks,  the  globes  of  the  eye  roll  to  the  right.  The 
digitalis  appears  to  produce  a  considerable  flow  of  urine. 
15.  All  her  symptoms  appear  worse.  16.  She  died  in 
convulsions. 

Dissection.  —  After  death,  the  brain  collapsed,  and  the 
tumor  at  the  fontanelle  disappeared.  On  removing  the 
cranium,  the  dura  mater  appeared  in  a  natural  state. 
After  separating  it  from  the  membrane  beneath,  the  blood- 
vessels, returning  the  blood  from  the  brain  to  the  different 
sinuses,  were  very  much  distended  with  coagulated  blood. 
In  some  of  them,  the  coagulating  lymph  appeared  dis- 
tinctly separated.  In  several  places  between  the  tunica 
arachnoides  and  pia  mater,  there  was  a  fluid  resembling 
pus,  together  with  a  considerable  quantity  of  serum. 
Upon  removing  that  portion  of  the  cerebrum  which  covers 
15 


170  APPENDIX    C. 

the  corpus  callosum,  there  appeared  a  distinct  fluctuation 
in  the  right  ventricle,  which  was  then  opened,  and  there 
issued  from  it  four  or  five  ounces  of  serum.  In  the  left 
ventricle  there  was  not  so  much  serum,  but  there  was  a 
quantity  of  matter  resembling  pus  rather  hardened.  The 
third  and  fourth  ventricles  contained  some  serum ;  and, 
indeed,  it  appeared  to  be  generally  diffused  throughout 
the  brain,  and  extended  down  the  spinal  marrow.  There 
was  an  inflammatory  crust  surrounding  the  optic  nerves, 
as  likewise  the  left  one  of  the  sixth  pair. 

These  were  the  principal  morbid  appearances  that  were 
discovered  upon  the  brain.  Upon  comparing  these  with 
the  foregoing  symptoms,  we  shall  discover  that  the  side  of 
the  body  most  affected  was  opposite  to  the  side  of  the 
brain  most  diseased,  and  vice  versa. 

Case  III. 

Of  a  Diseased  Stomach. 

Miss  R ,  aged  forty  years,  had  complained  for  seve- 
ral years  of  a  burning  pain,  as  she  expressed  it,  at  her 
stomach  ;  for  which  she  had  made  application  to  several 
physicians,  but  had  obtained  scarcely  any  mitigation  of 
her  complaint.  The  only  temporary  relief  she  could  pro- 
cure was  from  large  draughts  of  milk  and  water.  She 
died  June  17th,  1808.  It  was  the  desire  of  her  friends 
that  the  viscera  of  the  abdomen  should  be  examined.  On 
dividing  the  cellular  substance,  there  escaped  a  consider- 
able quantity  of  serum.  After  the  parietes  of  the 
abdomen  were  divided,  there  was  a  large  quantity  dis- 
charged, together  with  some  pus.  The  peritoneum  and 
the  peritoneal  coat  of  all  the  viscera  was  covered  with 
pus.  The  lower  part  of  the  stomach,  the  pylorus,  and  all 
the  duodenum  above  where  the  ductus  cholideous  commu- 


DISEASED    STOMACH.  171 

nis  enters  it,  were  very  much  enlarged  and  thickened, 
assuming  the  appearance  of  a  cancer.  On  handling  the 
tumor,  it  was  so  ulcerated  that  the  finger  readily  passed 
through  it,  and  some  ill-conditioned  matter  issued  out. 
On  laying  the  tumor  freely  open,  it  was  found  to  contain 
some  excrementitious  substance,  together  with  something 
resembling  the  dregs  of  indigo  and  flakes  of  charcoal. 
The  pancreas  was  very  much  enlarged,  and  in  a  scirrhous 
state,  and  adhered  to  the  stomach  and  duodenum.  The 
liver  appeared  in  a  pretty  healthy  state  ;  yet  the  gall  blad- 
der was  much  contracted,  and  was  very  firmly  attached  to 
the  tumor  of  the  stomach,  and  contained  a  small  quantity 
of  viscid  bile.  The  other  viscera  were  healthy,  excepting 
being  covered  with  pus,  as  was  before  mentioned. 


172 


APPENDIX    E. 


The  following  cases  of  tracheotomy,  with  the  remarks  thereon, 
were  read  before  the  New  Hampshire  Medical  Society,  at  its 
annual  meeting,  1830.  They  were  subsequently  published  in  the 
New  England  Quarterly  Journal,  vol.  i.  p.  305  :  Boston,  1843. 


CASES    OF   TRACHEOTOMY. 

In  the  great  variety  of  operations  which  the  surgeon  is 
called  upon  to  perform,  perhaps  there  is  no  one  more  ap- 
palling to  spectators,  or  which  requires  more  decision  and 
presence  of  mind  in  the  operator,  than  that  of  broncho- 
tomy  or  tracheotomy.  And  when  performed  for  the 
removal  of  a  foreign  substance  from  the  larynx  or  trachea, 
there  is  no  case  in  which  the  patient  receives  more  imme- 
diate and  manifest  relief,  and  in  which  the  skill  and  dex- 
terity of  the  surgeon  are  more  duly  appreciated.  Yet  the 
operation  itself,  if  properly  performed,  is  not  a  dangerous 
one. 

Case  I. 

August  5,  1827,  was  called  to  visit  a  child  aged  twenty- 
two  months,  and  found  her  with  symptoms  of  suffocation. 
The    report   given  by  her  parents   was,   that,  about  two 


CASES    OF    TRACHEOTOMY.  173 

hours  before,  she  had  been  playing  with  some  common 
field  beans,  had  put  some  of  them  into  her  mouth,  and,  in 
the  act  of  laughing,  they  supposed  one  of  the  beans  had 
slipped  into  the  windpipe.  She  was  immediately  seized 
with  a  difficulty  of  breathing,  with  occasional  paroxysms 
of  suffocation.  Upon  attentive  examination,  and  listen- 
ing to  the  manner  of  her  breathing,  I  came  to  the 
conclusion  that  the  bean  was  in  the  trachea,  near  its 
bifurcation,  and  probably  lodged  on  or  over  the  left  bron- 
chial tube,  as  the  lung  on  that  side  of  the  chest  did  not 
expand  in  respiration. 

The  necessity  of  an  operation  was  manifest,  and  was 
proposed  as  the  only  means  of  rescuing  the  child  from 
immediate  danger.  Her  parents  would  not  consent  to  it ; 
and,  as  the  foreign  substance  appeared  to  be  fixed  or  sta- 
tionary in  the  situation  it  then  was  in,  it  was  thought  not 
proper  to  urge  it  at  that  time.  The  attendants  were 
directed  to  watch  the  child  attentively,  and,  if  the  bean 
appeared  to  come  up  into  the  upper  part  of  the  trachea  or 
larynx,  and  strangle  her,  to  endeavor  to  force  it  back 
again  by  rubbing  or  pressing  the  throat  with  considerable 
force. 

I  then  left  the  patient,  and  was  absent  two  or  three 
hours.  Upon  my  return,  I  was  met  at  the  door  by  some 
one  saying,  "  The  child  was  dying."  I  found  her  with 
a  livid  countenance,  tossing  herself  about  in  various  direc- 
tions, and  gasping  for  breath.  By  pressing  and  rubbing 
the  larynx  and  trachea,  the  bean  appeared  to  descend 
again  to  its  former  situation.  An  operation  was  no 
longer  objected  to,  as  it  was  evident  she  must  have  imme- 
diate relief,  or  death  would  be  the  consequence. 

Preparations  were  soon  made.  The  child  was  placed 
upon  a  table  on  her  back,  with  a  roll  of  cotton  under  her 
neck,  and  her  head  bent  backward  over  it,  so  as  to  stretch 
15* 


174  APPENDIX    E. 

the  integuments  on  the  fore  part  of  the  neck,  which  was  very 
short  and  fleshy.  An  incision  was  made  through  the  skin 
and  cellular  substance,  extending  from  near  the  thyroid 
cartilage  to  the  sternum,  continuing  the  dissection  on  the 
fore  part  of  the  trachea.  Some  small  blood-vessels  were 
divided,  but  the  hemorrhage  was  not  so  profuse  as  to  delay 
the  operation.  The  thymus  gland,  apparently  very  large, 
was  next  observed  extending  up  the  trachea  till  it  came  in 
contact  with  the  thyroid  gland.  It  was  carefully  de- 
tached ;  and  the  assistants,  with  some  difficulty,  succeeded, 
with  small  blunt  hooks,  in  holding  the  two  glands  asunder 
sufficiently  to  denude  the  trachea,  through  which  an  inci- 
sion was  then  made,  nearly  half  an  inch  in  length.  The 
air  came  hissing  through  the  wound.  A  pair  of  small 
forceps  were  passed  into  the  trachea  and  up  through  the 
glottis,  by  which  it  was  ascertained  that  the  foreign  sub- 
stance was  not  above  the  opening.  Then  a  pair  of  com- 
mon dressing  forceps  were  introduced,  and  the  blades 
separated  so  as  to  hold  apart  the  sides  of  the  slit.  They 
were  but  just  placed  in  that  situation,  when  the  bean, 
during  some  little  struggle  of  the  child,  came  up,  and 
was  instantly  seized  with  the  forceps  and  removed.  The 
patient  was  turned  face  downwards  to  prevent  the  blood 
from  getting  into  the  trachea.  She  immediately  breathed 
easy  and  natural.  The  glands  and  integuments  closed 
over  the  slit,  so  that  no  air  escaped  through  it,  and  within 
five  minutes  she  was  sleeping.  After  letting  her  rest  for 
a  short  time,  the  wound  was  sponged  clean,  and  accurately 
brought  together  and  retained  by  strips  of  adhesive  plas- 
ter ;  a  small  compress  placed  upon  each  side,  and  secured 
by  a  roller  passed  several  times  round  the  neck.  She  was 
then  put  to  bed,  and  rested  quietly  through  the  night. 
The  next  day,  August  6,  when  I  visited  the  child,  found 
her  running  about  the  house,  apparently  well. 


CASES    OF    TRACHEOTOMY.  175 

August  8.  — Removed  the  dressings  for  the  first  time. 
The  wound  had  completely  adhered  by  the  first  intention, 
and  there  had  been  no  febrile  action  after  the  operation. 

August  12. —  The  dressings  were  discontinued,  and  the 
child  was  in  perfect  health. 

Case  II. 

March  1,  1830.  —  A  child,  aged  one  year  and  sixteen 
days,  laboring  under  a  slight  catarrhal  affection  or  in- 
fluenza, while  creeping  upon  the  floor,  put  a  piece  of 
broken  earthen  cup  into  the  mouth ;  and  in  the  act  of 
coughing  or  laughing,  as  stated  by  the  parents,  it  slipped 
into  the  throat,  and  produced,  in  their  language,  "  a 
choking,  or  an  inability  to  swallow,  and  a  difficulty  of 
breathing."  Within  half  an  hour  after  the  accident,  I 
saw  the  child ;  his  breathing  was  somewhat  hoarse  and 
hissing ;  but  his  friends  said,  "  Not  much  more  so  than 
before  the  accident  happened."  He  could  not  be  induced 
to  swallow  any  thing ;  but  when  a  little  water  was  put 
into  his  mouth,  after  holding  it  a  short  time,  he  ejected 
it.  A  probang  was  passed  into  the  oesophagus,  after 
which  he  swallowed  readily,  and  the  breathing  was  less 
impeded.  Some  castor  oil  was  administered,  and  mucilagi- 
nous drinks  directed. 

March  2.  —  Nine  o'clock,  a.m.  eighteen  hours  after  the 
accident,  the  father  of  the  child  came  running  to  me,  and 
said  he  was  suffocating ;  or,  to  use  his  expression,  "  was 
choking  to  death."  When  I  arrived,  they  had  the  child 
in  their  arms,  carrying  it  about  the  room  in  nearly  an 
erect  posture.  He  was  restless,  tossing  his  arms,  and  en- 
deavoring frequently  to  change  his  position.  His  coun- 
tenance was  livid,  his  breathing  very  much  impeded,  and 
sounded  hissing  and  husky,  and  was  only  in  gasps.     It 


176  APPENDIX    E. 

was  evident  that  the  foreign  substance  was  in  the  larynx 
or  trachea,  and  that  he  must  be  relieved  immediately  by 
an  operation,  or  death  would  ensue.  Preparations  were 
quickly  made  ;  and,  with  the  assistance  of  Dr.  J.  B.  Daus- 
man,  I  proceeded  in  the  operation.  The  child  was  placed 
upon  a  table  on  his  back,  a  small  pillow  rolled  hard  and 
placed  transversely  under  his  neck,  and  his  head  bent 
back  over  it  so  as  to  elevate  his  chin  and  make  the  integu- 
ments tense,  and  the  cartilages  of  the  larynx  and  trachea 
prominent. 

An  incision,  two  inches  in  length,  was  made  through  the 
integument.  The  thyroid  and  guttural  veins  were  seen, 
very  turgid.  They  were  carefully  detached  sufficiently 
to  be  pushed  aside,  and  were  not  divided.  Continuing 
the  dissection  on  the  fore  part  of  the  trachea,  an  artery, 
the  thyroidea  anastomotica,  was  divided.  At  first,  it 
bled  very  freely,  so  that  we  were  obliged  to  suspend  the 
operation  a  few  minutes.  The  bleeding  soon  ceased  ;  an 
incision  was  then  made  through  the  trachea,  half  an  inch 
in  length.  The  air  came  freely  through  the  wound,  and 
the  child  breathed  with  more  ease.  After  delaying  a 
short  time,  that  he  might  in  some  measure  recover  from 
his  exhausted  and  suffocated  state,  a  small  pair  of  forceps 
were  passed  through  the  slit  in  the  trachea  upwards 
towards  the  glottis.  It  immediately  came  in  contact  with 
the  piece  of  earthen  cup,  and  the  sound  was  distinctly 
heard  by  the  bystanders.  Every  attempt  to  seize  it  with 
the  forceps  proved  ineffectual.  A  probe  was  then  curved 
and  passed  into  the  trachea,  and  endeavors  made  to  dis- 
lodge it,  but  did  not  succeed  ;  during  which  the  child 
struggled  much,  and  at  length  became  so  much  exhausted, 
that  the  spectators  thought  him  about  expiring.  A  large 
probe  was  then  introduced,  and  with  it  the  foreign  sub- 
stance was  pushed  up  through  the  glottis  into   the  pha- 


CASES    OF    TRACHEOTOMY.  177 

rynx,  and  the  child  swallowed  it.  Afterwards  a  bougie 
was  passed  up  throgh  the  larynx  and  glottis,  with  which 
it  was  ascertained  that  all  obstruction  was  removed. 

In  the  various  attempts  made  to  dislodge  this  substance, 
it  was  pretty  well  ascertained  that  it  was  sharp  and  an- 
gular, and  being  so  firmly  fixed  that  it  required  consider- 
able force  to  push  it  into  the  pharynx.  The  probability 
was  that  the  delicate  and  sensible  membrane,  lining  the 
larynx  and  upper  part  of  the  trachea,  was  very  much 
lacerated  and  wounded.  Under  these  circumstances,  it 
was  thought  advisable  not  to  close  the  wound,  that  respi- 
ration might  go  on  by  the  air  passing  through  the  slit  in 
the  trachea,  in  case  that  the  subsequent  inflammation 
should  be  so  great  as  to  close  the  glottis,  and  prevent  it 
passing  that  way.  Some  superficial  dressings  were  ap- 
plied ;  but  a  portion  of  the  incision  was  left  open  and 
naked.  The  child  was  then  put  into  bed  ;  and,  although 
very  much  exhausted,  his  respiration  was  tolerably  free 
and  easy.  In  the  evening  he  was  very  quiet,  had  slept 
some,  and  had  taken  some  light  nourishment.  The  air 
had  occasionally  passed  through  the  wound. 

March  3.  —  There  was  considerable  febrile  action  ;  the 
breathing  was  rather  more  laborious  ;  some  portion  of  the 
air  passed  through  the  incision  at  almost  every  breath.  A 
cathartic  of  castor  oil  was  administered.  In  the  evening, 
the  oil  had  purged  two  or  three  times,  and  he  was  resting 
quietly,  breathing  as  in  the  morning. 

March  4.  —  The  external  parts  appeared  considerably 
swollen  and  inflamed.  In  respiration,  the  air  passed 
wholly  through  the  incision  in  the  trachea.  The  glottis 
was  apparently  closed  by  the  inflammation,  and  he  could 
make  no  vocal  sound.  Six  grains  of  calomel  was  to  be 
given,  followed  with  castor  oil  to  purge  freely. 

March  5. — The  cathartic  had  operated  several  times; 


178  APPENDIX    E. 

but  the  symptoms  continued  much  as  they  were  on  the 
fourth. 

March  6.  —  Suppuration  had  commenced  in  the  wound, 
and  he  breathed  at  intervals  rather  laboriously.  The  air 
continued  to  pass  wholly  through  the  opening  in  the  tra- 
chea.    He  could  neither  cry  aloud,  nor  make  any  noise. 

March  7.  —  Suppuration  was  copious :  he  coughed  a 
good  deal,  and,  when  coughing,  some  air  was  forced 
through  the  glottis,  carrying  with  it  pus  and  mucus. 

March  8,  9.  —  He  appeared  to  be  failing;  took  but  lit- 
tle nourishment.  Suppuration  continued  very  copious, 
pus  very  thick  and  glutinous ;  and,  when  any  of  it  was 
carried  with  the  air  through  the  wound  in  the  trachea,  it 
produced  violent  fits  of  coughing  and  strangulation.  At 
intervals,  that  is,  after  he  had  expelled  a  good  deal  of  pus 
and  mucus  during  a  paroxysm  of  coughing,  he  breathed 
more  freely,  and  mostly  through  the  glottis ;  could  cry 
aloud,  and  articulate  some  words. 

March  10.  —  His  breathing  was  more  laborious,  with 
apparent  inability  to  cough  and  expectorate.  Granula- 
tions had  sprung  up  in  the  wound,  and  appeared  to  im- 
pede the  passage  of  the  air ;  and,  either  from  inability  or 
disinclination,  he  had  ceased  taking  any  nourishment,  and 
his  mouth  and  jaws  were  covered  with  aphthce,  for  which 
a  gargle  of  borax  and  honey  was  prescribed. 

March  11.  —  In  the  morning,  a  messenger  came  in 
great  haste,  and  said  "  the  child  was  suffocating."  I 
found  him  breathing  very  laboriously  and  croupy.  Coun- 
tenance livid,  with  the  expression  of  great  anxiety; 
unable  to  make  any  sound.  Granulations  had  nearly 
filled  up  the  wound.  The  incision  in  the  throat  was 
mostly  covered  by  them,  and  the  trachea  itself  in  that 
part  appeared  very  much  contracted,  which  was  ascer- 
tained by  passing  a  probe  through  the  opening ;  but  very 


CASES    OF    TRACHEOTOMY.  179 

little  air  appeared  to  pass  into  the  lungs  any  way.  In 
this  situation,  we  concluded  the  indication  was,  if  possi- 
ble, to  dilate  the  stricture  of  the  trachea,  and  to  clear  it 
of  the  tenacious,  muco-purulent  secretion,  with  which  it 
appeared  to  be  filled.  With  that  view  I  passed  a  pretty 
large-sized  urethra  bougie  into  the  trachea,  and  first 
passed  it  up  through  the  glottis,  and  afterwards  passed 
it  downwards  towards  the  lungs.  It  produced  consider- 
able coughing,  and  a  good  deal  of  mucus  and  pus  was 
discharged  into  the  mouth,  and  either  ejected  or  swal- 
lowed, and  some  came  through  the  wound.  This  appeared 
to  give  immediate  relief:  it  restored  his  voice,  and  he 
breathed  with  much  more  ease.  A  decoction  of  seneca 
and  squills,  prepared  after  the  formula  for  Coxe's  hive- 
syrup,  was  directed  to  be  given  in  doses  of  a  teaspoonful 
every  half-hour,  till  it  produced  vomiting,  and  the  gargle 
of  borax  and  honey  to  be  continued.  In  the  evening,  the 
child  had  vomited  several  times,  and  had  two  or  three 
alvine  discharges :  breathed  more  freely,  and  took  some 
nourishment. 

March  12.  —  Much  improved  ;  respiration  was  natural 
and  easy ;  but  little  air  escaped  through  the  wound,  and 
that  only  when  he  coughed,  cried,  or  was  agitated.  He 
took  sufficient  food,  and  the  aphthous  appearance  of  the 
mouth  was  principally  removed. 

March  14.  —  He  had  gained  rapidly.  He  was  sitting 
up  in  bed,  diverting  himself  with  playthings,  and  breathed 
perfectly  natural. 

March  10.  —  He  had  continued  to  improve.  The  open- 
ing in  the  trachea  was  closed,  the  wound  filled  up  and 
nearly  cicatrized.     Discontinued  my  visits. 

April  4.  —  Called  to  see  my  patient ;  found  him  in  per- 
fect health.  The  cicatrization  of  the  wound  had  been 
complete  for  several  days. 


180  APPENDIX    E. 


Case  III. 


March  30, 1830.  —  Was  called  to  visit  S.  W.  aged  four 
years  and  four  months.  Met  in  consultation  with  Drs. 
Carpenter,  E.  Hatch,  and  Bliss,  at  eight  o'clock,  a.m. 
The  report  given  by  the  parents  of  the  child  was,  that,  the 
evening  before,  she  was  amusing  herself  with  some  large 
kidney-shaped  garden  beans.  She  had  some  of  them  in 
her  mouth,  and  by  some  means  one  of  them  slipped  into 
the  windpipe.  She  was  immediately  seized  with  a  diffi- 
culty of  breathing,  which  had  continued  ever  since,  with 
occasional  violent  suffocating  attacks.  At  the  time  of  our 
consultation,  the  breathing  was  hissing  and  husky ;  and, 
by  auscultation,  we  found  that  the  right  bronchial  tube 
was  obstructed,  and  concluded  that  the  bean  was  lodged 
near  the  bifurcation  of  the  trachea.  An  operation  was 
immediately  determined  upon,  as  the  only  means  of  afford- 
ing the  relief  the  case  so  urgently  required. 

Preparations  were  soon  made,  and  the  child  placed 
upon  a  table,  as  in  the  preceding  cases.  An  incision  was 
made  through  the  integuments  two  inches  in  length.  The 
dissection  was  continued  till  the  fore  part  of  the  trachea 
was  laid  bare.  No  blood-vessel  of  importance  was 
divided,  and  there  was  no  hemorrhage  to  impede  the  ope- 
ration. A  longitudinal  incision  was  then  made  into  the 
trachea,  rather  more  than  half  an  inch  in  length.  The 
air  passed  freely  through  the  wound.  The  bean  soon 
made  its  appearance,  presenting  its  broad  or  flat  side  to 
the  slit  in  the  trachea,  the  sides  of  which  would  not  sepa- 
rate sufficiently  to  let  it  pass.  Endeavoring  to  seize  it 
with  a  pair  of  forceps,  it  slipped  from  my  grasp,  was 
forced  up,  and  stuck  fast  in  the  larynx  or  glottis,  which 
it  so  completely  filled,  that  it  prevented  any  air  passing 
that  way.     An  attempt  was  made  with  a  large  probe  to 


CASES    OF    TRACHEOTOMY.  181 

force  the  bean  up  through  the  glottis  ;  but  it  was  so  laro-e 
it  would  not  pass  without  too  much  violence.  The  child 
at  that  time  struggled  considerably,  and  the  assistants 
who  held  apart  the  sides  of  the  incision  lost  their  hold. 
The  integuments  of  the  neck,  which  was  very  fleshy,  im- 
mediately closed  over  the  opening  in  the  trachea,  and 
stopped  respiration  entirely.  The  lungs  collapsed,  the 
child  straightened  herself,  her  countenance  became  livid, 
her  eyes  motionless  and  glassy.  The  spectators  declared 
she  was  dead.  The  sides  of  the  incision  were  instantly 
separated  and  held  asunder  by  the  assistants,  and  the 
blades  of  a  pair  of  dressing  forceps  were  introduced  into 
the  slit  in  the  trachea,  and  with  them  the  sides  were  kept 
apart;  but  no  air  passed — respiration  did  not  return  — 
the  child  was  still  motionless.  I  called  for  a  tube  or  some 
instrument  to  inflate  the  lungs ;  but  the  agonized  feelings 
of  the  friends,  and  the  agitation  of  the  attendants  and 
spectators,  prevented  their  heeding  my  call,  or  rendering 
any  assistance.  I  then  seized  a  bougie  which  was  at 
hand,  passed  it  through  the  wound  into  the  trachea  down- 
wards towards  the  lungs,  at  the  same  time  directed  an 
assistant  to  press  the  chest  in  different  directions  with  his 
hands.  The  bougie  appeared  to  irritate  and  produce 
some  little  motion  in  the  chest ;  and,  upon  removing  it, 
some  little  air  appeared  to  rush  into  the  lungs.  The  mo- 
tion of  the  chest  increased,  respiration  was  gradually 
restored,  and  life  and  action  returned.  She  swallowed  a 
few  drops  of  camphorated  spirit.  I  then  passed  a  pair  of 
small  forceps  up  towards  the  glottis,  seized  the  bean,  and 
removed  it. 

She  immediately  breathed  free  and  easy.     As  soon  as 
she  had  recovered  a  little  from  her  exhaustion,  the  wound 
was  sponged  clean,  and  dressed  with  strips  of  adhesive 
plaster ;  and  she  was  put  to  bed,  and  was  soon  asleep. 
16 


182  APPENDIX    E. 

The  next  day,  March  31,  one  o'clock,  p.m.  there  was 
considerable  febrile  excitement,  with  croupy  breathing. 
A  cathartic  of  calomel  and  jalap  was  given,  and  followed 
by  sulphate  of  magnesia,  which  purged  freely  and  gave 
relief.  A  solution  of  tartarized  antimony  was  directed  to 
be  given  occasionally  till  the  febrile  symptoms  were  re- 
moved. 

April  2.  —  The  wound  was  dressed,  and  very  little  air 
escaped  through  the  incision.  It  had  principally  adhered 
by  the  first  intention. 

April  7.  —  The  incision  was  entirely  healed,  and  the 
child  in  perfect  health. 


183 


APPENDIX    F. 


THE  PRESENT  CONDITION  OF  THE  MEDICAL 
PROFESSION ; 

THE  IMPEDIMENTS  TO  ITS  PROGRESS  AND  REPUTATION;  WITH  SUG- 
GESTIONS ON  THE  PROPER  METHODS  TO  BE  PURSUED  FOR  THE 
ARREST  OF  EMPIRICISM  ;  —  AN  ADDRESS  DELIVERED  AT  THE  AN- 
NUAL  MEETING   OF  THE   NEW   HAMPSHIRE   MEDICAL   SOCIETY. 

Gentlemen,  —  Occupied,  as  I  have  constantly  been,  in 
the  practice  of  our  laborious  profession,  I  have  found  no 
leisure  to  digest,  and  prepare  for  the  present  occasion,  a 
regular  essay  upon  any  medical  topic.  But  the  honora- 
ble station  in  which,  by  the  suffrages  of  this  society,  I  am 
placed,  imposes  upon  me  the  duty  of  addressing  you  upon 
some  subject  connected  with  medicine. 

Ever  anxious  to  see  the  character  of  our  common  pro- 
fession elevated  to  a  proper  standing,  which  will  exempt 
it  alike  from  a  suspicion  of  selfishness  and  from  being  the 
butt  of  ridicule  among  all  classes  of  society,  and  placed 
on  an  eminence  which  will  command  the  respect  and  de- 
serve the  confidence  of  the  community  at  large,  I  have 
been  induced  at  this  time  to  occupy  your  attention,  a  very 
few  moments,  with  some  reflections  upon  the  present  con- 
dition of  the  medical  profession,  and  an  inquiry  into  the 
causes  which  hinder  its  advancement,  and  what  course  we 


184  APPENDIX    F. 

ought  to  pursue  to  promote  its  respectability,  and  to  re- 
tard the  progress  of  empiricism,  or  banish  it  from  amongst 
us. 

Within  the  last  half-centuiy,  there  has  been  a  very 
rapid  improvement  in  the  science  of  medicine;  under  which 
title  I  wish  to  be  understood  to  include,  not  only  the 
science  which  is  at  present  so  denominated,  but  likewise 
surgery,  which  was  formerly  the  case.  Within  the  period 
named,  there  have  been  great  numbers  who  have  engaged 
in  the  pursuit,  who  have  brought  with  them  a  vast  fund 
of  talents,  industry,  and  acquirements,  the  whole  of  which 
they  have  unremittingly  devoted  to  the  subject :  in  short, 
almost  all  those  who  are  now  engaged  in  the  profession 
appear  to  pursue  it  with  an  ardor  heretofore  unexampled. 
Medical  schools  have  now  become  very  numerous  and 
respectable,  wrhere  medicine  and  its  collateral  branches  are 
taught  and  studied  in  a  systematic  manner.  From  these 
fountains  issue  annually  many  young  men,  not  only  well 
informed  in  the  principles  of  the  profession,  but  possess- 
ing talents  and  industry  to  pursue  it  with  credit  to  them- 
selves, and  advantage  to  the  public.  As  a  natural  result 
from  the  causes  we  have  named,  the  fact  is,  that  the  regu- 
lar profession  generally  is  now  much  more  learned  and 
better  qualified  to  practise  than  formerly,  and  are  much 
better  entitled  to  the  confidence  and  patronage  of  society. 
But  do  they  obtain  it?  Are  they  any  more  respected 
now  than  they  were,  when  their  whole  stock  of  medical 
information  was  contained  in  a  bundle  of  recipes  ?  Do 
we  not  see  the  ignorant  and  itinerant  quack  still  employed 
to  their  exclusion  ?  If  this  is  the  fact,  —  and  I  think  no 
one  can  doubt  it,  —  how  is  it  that  the  public  are  thus 
imposed  upon  ?  and  how  shall  the  evil  be  remedied  ? 

The  liability  of  mankind  to  imposition,  and  of  becom- 
ing the  dupes  of  the  cunning  and  crafty,  is  in  an  inverse 


CONDITION    OF    THE    MEDICAL    PROFESSION.  I8t) 

proportion  to  their  intelligence  and  general  information. 
Wherever  we  find  the  common  mass  of  people  well  in- 
formed, not  only  in  the  objects  of  their  particular  pursuit, 
but  upon  subjects  generally,  —  that  is,  they  have  been 
from  their  infancy  rationally  and  philosophically  edu- 
cated, —  there  we  find  no  impostor  fattening  upon  their 
credulity ;  but  where  we  find  them  generally  ignorant, 
and  consequently  credulous  and  superstitious,  there  we 
find  the  hypocritical  and  fanatical  priest,  the  pettifogging 
lawyer,  and  quack  doctor. 

It  is  a  lamentable  fact,  that  the  learned  professions  have 
heretofore  found  it  too  much  for  their  interest  to  keep  the 
rest  of  mankind  in  ignorance  ;  and,  by  so  doing,  they  have 
frequently  obtained,  not  only  the  good  things  of  this 
world,  but  a  character  for  learning,  wisdom,  and  sanctity, 
to  which  they  were  not  entitled,  either  by  their  talents, 
integrity,  or  acquirements. 

If  we  recur  to  the  history  of  medicine,  as  handed  down 
to  us  by  its  professors,  we  shall  find  that  the  practition- 
ers in  the  art  or  science  have  always  been  induced  to 
assume  some  mysterious  or  supernatural  skill,  and  have 
studiously  endeavored  to  keep  their  patients  in  ignorance, 
by  clothing  their  prescriptions  in  a  technical  garb,  and  by 
holding  their  communications  with  each  other  in  a  lan- 
guage intelligible  only  to  themselves ;  thus  inspiring  the 
uninformed  with  a  belief,  that  there  is  something  in  the 
profession  beyond  the  comprehension  of  ordinary  minds, 
and  that  they  have  been  supernaturally  endowed  with 
faculties  which  enable  them  to  penetrate  into  and  com- 
prehend all  the  mysteries  of  nature. 

Even  in   this  country,  where  the  principles  of  all  the 

other  arts  and  sciences  are  placed  within  the  reach  and 

comprehension  of  the  common  people,  that  of  medicine  is 

still,  in  a  great  measure,  hidden  from   their  view.     The 

16* 


186  APPENDIX    F. 

language  of  medical  men  and  medical  writers  is  not 
brought  to  the  understanding  of  mankind  generally ;  it 
is  not  the  common  language  of  this  country,  nor  of  any 
other  country  now  existing  upon  earth. 

So  long  and  so  generally  has  this  method  of  writing 
and  speaking  prevailed  among  the  most  learned  of  the 
profession,  that  now,  the  physician  and  surgeon,  who,  in 
his  intercourse  with  his  patients,  should  use  a  language 
perfectly  intelligible  to  them,  would  be  considered  by 
many  as  very  unlearned,  and  not  deserving  of  their 
confidence.  Is  it  strange,  then,  if  the  regular  and  learned 
physician  thus  keeps  himself  aloof,  and  suffers  not  the 
common  mass  of  people  to  approach  him  and  know 
him,  that  the  crafty  quack,  destitute  alike  of  information 
and  moral  honesty,  should  frequently  palm  himself  upon 
the  public  as  one  of  those  duly  initiated  into  all  those 
mysteries  which  are  supposed  to  belong  to  the  profession  ? 

All  this  secrecy  and  mystery  in  the  practice  of  medicine 
is  an  imposition,  is  quackery,  let  who  will  adopt  it ;  and, 
so  long  as  there  is  so  much  of  it  in  the  profession,  persons 
of  common  education  cannot  discover  the  difference  be- 
tween the  learned  quack  and  the  ignorant  one.  A  few 
years  since,  a  gentleman,  after  having  had  an  interview 
with  a  noted  empiric  whose  fame  was  then  spreading  far 
and  wide,  observed  to  me,  "  Well,  I  have  been  to  see  the 
Indian  doctor."  And  what  do  you  think  of  him  ?  "I 
cannot  for  my  life  discover  in  any  thing  why  he  is  not  as 
learned  and  as  skilful  as  any  M.D.  I  ever  saw.  He  con- 
verses in  a  language  as  unintelligible  as  the  best  of  you." 
1  considered  this  a  severe  and  just  rebuke  upon  the  pro- 
fession generally. 

There  are  various  ways  of  playing  the  quack.  As  Rush 
observes,  "  It  is  not  necessary  for  this  purpose  that  a  man 
should  advertise  his  skill  or  his  cures,  or  that  he  should 


QUACKERY    IN    THE    MEDICAL    PROFESSION.  187 

mount  a  phaeton  and  display  his  dexterity  in  operating  to 
an  ignorant  and  gaping  multitude.  A  physician  acts  the 
same  part  in  a  different  way,  who  assumes  the  character 
of  a  madman  or  a  brute  in  his  manners,  or  who  conceals 
his  fallibility  by  an  affected  gravity  and  taciturnity  in  his 
intercourse  with  his  patients.' 

There  are  some  who  are  continually  boasting  how  much 
more  successful  they  are  in  their  practice  than  their  neigh- 
bors,—  of  the  marvellous  cures  and  operations,  which,  in 
fact,  they  have  never  effected  or  performed.  Others  mag- 
nify the  danger  and  importance  of  the  most  trifling  indis- 
position, or  make  a  great  parade  about  any  surgical 
operation,  let  it  be  ever  so  simple,  by  calling  in  a  large 
number  of  physicians  and  surgeons  to  hold  a  council  (as 
they  term  it)  upon  the  case ;  thus  unnecessarily  alarming 
the  patient  and  his  friends,  for  no  visible  purpose,  unless 
it  be  to  secure  a  retreat  from  blame  if  they  are  unsuc- 
cessful, or  to  enhance  their  credit  should  they  effect 
a  cure,  and  enable  them  to  augment  the  amount  of  their 
charge  for  services. 

Some  boast  of  their  superior  attainments,  and  of  the 
great  opportunities  they  have  had  for  acquiring  medical 
information.  I  know  a  physician,  who  was  never  in  his 
life  a  hundred  miles  from  the  place  of  his  nativity ;  yet 
he  says  it  must  be  strange  if  he  does  not  know  more 
than  other  practitioners  in  his  neighborhood.  He  says, 
and  many  believe  it,  that  he  has  obtained  all  the  in- 
formation that  was  to  be  had  from  the  best  medical 
schools  in  this  country,  and  then  he  has  spent  two  or 
three  years  in  Europe.  He  is  intimately  acquainted  and 
corresponds  with  all  of  the  most  eminent  and  learned 
men  in  the  profession.  What  they  know,  he  knows  ; 
whatever  they  learn  or  discover,  they  immediately  com- 
municate to  him. 


188  APPENDIX    F. 

When  a  patient,  upon  -whom  he  had  been  attending  a 
long  time,  expressed  a  wish  for  other  advice,  he  said,  "  I 
have  written  to  the  greatest  doctor  in  England,  and  stated 
your  case  to  him,  and  he  has  sent  me  a  medicine  which 
he  says  never  fails  in  such  cases.  You  had  better  delay 
calling  other  advice,  till  I  have  had  an  opportunity  to 
give  it  a  fair  trial."  This  course  had  the  desired  effect : 
it  prevented  at  that  time  the  consultation,  which  he 
dreaded.  How  much  less  deception  and  falsehood  was 
here,  than  is  practised  by  the  ignorant  impostor,  who 
boasts  of  having  obtained  his  skill  of  the  Indians  ! 

There  are  some  physicians,  who  are  very  well  qualified, 
who  deceive  and  impose  upon  their  patients  by  administer- 
ing inert  or  useless  remedies,  and  by  taxing  them  for 
much  unnecessary  attention.  Within  the  last  year,  a 
young  gentleman  of  a  fair  mind,  well  educated  in  the  pro- 
fession, possessing  liberal  and  correct  principles,  com- 
menced practice  in  a  town  in  this  state.  He  was  called 
to  visit  a  child  in  a  respectable  family  :  he  found  it 
affected  with  some  slight  febrile  symptoms.  He  pre- 
scribed the  remedies  he  thought  indicated  ;  but  the  anxiety 
of  the  parents  was  such  that  they  were  unwilling  to  trust 
the  young  doctor  alone,  and  an  older  one  was  called.  He 
came  and  examined  the  case,  and  was  informed  of  the 
treatment  which  had  been  pursued.  He  inquired,  "  Did 
you  give  the  submuriates  r  "  meaning  calomel ;  which  name 
he  avoided,  lest  it  should  be  understood  that  a  portion  of 
mercury  had  been  administered :  he  was  answered  in  the 
affirmative.  He  then  took  the  young  physician  aside,  to 
hold  a  consultation,  as  he  termed  it.  When  by  them- 
selves, he  said  to  him,  "  You  have  treated  the  case  very 
properly,  and  have  done  all  the  case  really  requires  ;  but 
that  will  not  do  :  you  must  give  more  medicine,  or  you 
will  never  never  be  able  to  satisfy  the  people,  and  obtain 


CONDITION    OF    THE    MEDICAL    PROFESSION.  189 

their  confidence.  In  this  case,  I  should  advise  you  to 
color  some  water,  or  a  weak  solution  of  nitre,  with  red 
sanders,  and  give  the  child  a  teaspoonful  once  in  two  or 
hours,  until  it  recovers  its  usual  health." 

A  few  days  afterwards,  the  young  gentleman  called 
upon  me,  and  inquired  if  such  was  the  course  that  regular 
physicians  generally  pursued,  and  whether  this  society 
tolerated  such  practice. 

The  following  circumstances  were  related  to  me  by  a 
respectable  clergyman  of  this  State  :  A  farmer,  one  of  his 
parishioners,  had  the  misfortune  to  fall  from  his  cart,  and 
one  of  the  wheels  passed  over  him,  directly  across  his  ab- 
domen. Although  the  vehicle  was  not  heavily  loaded, 
yet  he  was  somewhat  bruised,  and  very  much  frightened. 
A  messenger  was  despatched  with  all  possible  haste  for 
the  doctor  who  resided  in  the  neighborhood,  who  came 
with  due  speed,  and,  as  a  thing  of  course,  bled  him 
largely,  and  administered  a  dose  of  castor  oil.  The  doctor 
was  then  informed  that  they  had  sent  for  a  surgeon,  who  re- 
sided some  twenty  or  thirty  miles  distant,  whose  reputation 
was  unrivalled  in  that  part  of  the  country.  The  next  day, 
the  minister  was  sent  for,  who,  with  the  neighboring  physi- 
cian, was  present  when  the  surgeon  arrived.  The  patient 
had  passed  the  night  with  a  great  deal  of  anxiety,  although 
with  but  little  pain.  The  arrival  of  the  great  doctor  was 
announced,  the  family  and  friends  all  crowded  around  the 
bed  of  the  patient,  the  surgeon  entered  the  room,  with  his 
saddle-bags  upon  his  arm,  and  turned  his  eyes  directly 
upon  the  wounded  man.  He  stood  several  minutes  gaz- 
ing upon  him,  during  which  time  his  countenance  put  on 
the  most  direful  and  portentous  aspect.  At  length  he 
shook  his  head,  set  down  his  saddle-bags,  and  laid  off  his 
hat,  drew  up  a  chair,  and  seated  himself  by  the  bed, 
placing  one  hand  upon  the  abdomen  of  the  patient,  and 


190  APPENDIX    F. 

with  the  other  felt  his  pulse,  and  said  nothing.  Some 
minutes  passed  in  this  manner,  when  the  deathlike  silence 
of  the  room  was  interrupted  by  the  anxious  and  affec- 
tionate wife,  tears  streaming  down  her  cheeks,  by  "  Doc- 
tor, what  do  you  think  ? r'  A  shake  of  the  head  was  the 
only  reply.  The  children  burst  into  tears.  One  little 
urchin,  too  young  to  fully  realize  what  was  going  on, 
hearing  the  sobs  of  his  brothers  and  sisters,  threw  down 
the  cat  with  which  he  was  playing,  and  ran  to  his  mother 
for  an  explanation.  Unfortunate  for  poor  puss,  the  doctor 
espied  him,  seized  him  by  the  hind  legs,  and  smashed  his 
head  upon  the  hearth,  drew  forth  a  knife,  and  convinced 
the  spectators  that  he  was  a  dexterous  operator,  by  in- 
stantly depriving  the  cat  of  her  skin,  and  applying  it 
directly  upon  the  abdomen  of  the  suffering  man,  again 
seating  himself  with  one  hand  upon  the  wrist,  feeling  the 
pulse ;  in  which  posture  he  continued  half  an  hour,  and 
then,  for  the  first  time  after  his  arrival,  broke  silence  by 
inquiring  if  they  had  any  sheep.  Being  answered  in  the 
affirmative,  he  requested  that  a  skin  might  be  stripped 
from  one  of  them,  and  brought  to  him  immediately  ;  which 
was  accordingly  done.  The  doctor  instantly  removed  the 
cat-skin,  and  enveloped  the  patient  in  the  warm  sheep- 
skin, and  continued  silently  watching  him  as  before.  The 
anxiety  of  the  patient  and  family  was  extreme  during  this 
farce,  which  was  manifested  by  the  inquiry  of  "Doctor, 
what  do  you  think :  is  there  no  hope  r "  but  not  a  word 
could  they  obtain.  After  remaining  in  suspense  nearly 
an  hour  longer,  closely  watching  the  countenance  of  the 
doctor,  they  discovered  that  the  muscles  of  his  face  began 
to  relax.  At  length  he  smiled,  and  then  broke  silence 
and  said,  "  We  have  gained  it ;  you  are  safe  !  If  I  had 
been  five  minutes  later,  all  the  world  could  not  have  saved 
vou  :   the  mortification  was  just  beginning." 


PREVENTION  OF  QUACKERY.  191 

In  the  course  of  a  day  or  two,  the  farmer  was  able  to 
pursue  his  labor  as  usual,  believing  that  his  life  was  pre- 
served by  the  great  skill  of  the  surgeon. 

Numerous  other  instances  might  be  related,  if  not 
equally  ridiculous  and  absurd  as  those  we  have  named, 
yet  very  improper  in  any  gentleman  of  the  profession  who 
wishes  to  be  considered  an  honorable  and  honest  practi- 
tioner. 

If  such  are  the  impositions  and  deceptions  practised  by 
regular  physicians,  as  they  are  called,  by  those  who  have 
had  the  honorable  degree  of  Doctor  in  Medicine  conferred 
upon  them,  and  are  in  regular  standing  in  respectable  me- 
dical societies,  it  will  be  in  vain  for  our  legislature  to 
enact  laws  against  the  ignorant  pretender.  So  long  as 
there  are  learned  and  licensed  quacks  in  this  country,  so 
long  will  the  ignorant  and  unlicensed  ones  obtain  patro- 
nage from  the  public. 

The  most  rational,  and  I  presume  the  only  successful, 
method,  for  us  to  combat  quackery,  will  be,  in  the  first 
place,  to  avoid  it  ourselves ;  and  then  endeavor  to  en- 
lighten the  common  people  as  much  as  possible.  Let 
them  understand  that  the  principles  of  the  profession  are 
founded  upon  reason  and  science,  and  that  we  are 
governed  by  those  principles.  We  make  no  pretensions 
to  supernatural  powers.  Let  us  banish  all  technical 
phraseology  from  our  conversation  and  prescriptions,  if 
not  from  our  pharmacopoeias.  Let  us  be  unwearied  in  our 
efforts  to  investigate  the  nature  and  causes  of  disease,  and 
the  effects  of  remedies.  When  called  to  the  bed  of  sick- 
ness, let  us  be  very  critical  in  our  inquiries  and  examina- 
tions, and  patiently  investigate  every  circumstance  relating 
to  the  case ;  and,  after  having  formed  an  opinion,  let  us 
be  candid  in  stating  our  views  of  the  case  to  the  patient 
or  his  friends,  explain  to  them,  if  possible,  the  location 


192  APPENDIX    F. 

and  nature  of  the  disease,  the  indications  of  cure  which 
are  to  be  pursued,  and  the  remedies  we  intend  to  pre- 
scribe, with  the  effect  we  expect  they  will  produce.  If 
we  have  any  doubt  in  the  case,  or  think  we  do  not  rightly 
understand  it,  let  us  acknowledge  it,  and  call  for  advice, 
if  thought  necessary. 

By  pursuing  this  course,  we  shall  soon  enlighten  the 
common  mass  of  people,  so  that  they  will  in  a  measure 
comprehend  the  general  principles  of  the  profession ;  and 
thus  we  shall  obtain  their  confidence,  and  quackery  and 
quacks  will  soon  be  banished  from  amongst  us,  without 
the  aid  of  legislative  enactments. 


193 


APPENDIX    G. 


This  affidavit,  relative  to  fracture  of  the  femur,  was  found  among 
Dr.  Twitchell's  manuscripts.     Its  date  is  unknown. 


FRACTURE  OF  THE  THIGH-BONE,  AND  THE  LIABI- 
LITY TO  A  SUBSEQUENT  DEFORMITY  OF  THE 
LIMB. 

I,  Amos  Twitchell,  of  lawful  age,  do  testify  and  say, 
that  I  have  ever  considered  a  fracture  of  the  thigh-bone 
attended  with  a  great  risk  of  deformity,  in  the  hands 
of  even  the  best  of  surgeons.  I  have  been  uniformly  of 
opinion,  that,  let  the  reduction  and  first  dressing  be  ever 
so  skilfully  performed,  it  would  be  of  little  importance, 
unless  the  subsequent  management  was  judicious,  and 
adapted  to  the  circumstances  as  they  occur  from  time  to 
time,  ever  maintaining  an  inflexible  command  over  the 
patient;  restraining  and  directing  him  in  all  his  mo- 
tions. Believing  this,  I  have  sometimes  refused  to  visit 
a  patient  for  the  purpose  of  reducing  a  broken  thigh,  who 
lived  at  the  distance  of  twenty  or  thirty  miles;  think- 
ing that  my  services  would  benefit  him  but  little,  as  I 
could  not  control  the  subsequent  treatment,  and  knowing 
that  all  deformity  which  might  occur  in  the  limb  would 
probably  be  unjustly  attributed  by  the  ignorant  to  the 
•surgeon  who  first  dressed  it.  This  was  the  case  with  a 
17 


194  APPENDIX    G. 

person  with  whom  I  am  acquainted,  whose  thigh  was 
broken.  Dr.  Nathan  Smith,  being  in  the  neighborhood, 
was  called :  he  reduced  and  dressed  the  limb.  After- 
wards, owing  to  the  restlessness  of  the  patient,  it  was  dis- 
placed, and  was  never  attempted  to  be  righted  by  the 
attending  surgeon.  The  consequence  was,  the  man  was 
a  cripple,  and  Dr.  Smith  received  the  opprobrium  of  many. 
In  cases  which  have  fallen  under  my  care,  I  have  con- 
sidered that  I  have  done  but  little  towards  securing  to  the 
patient  a  good  limb,  by  reducing  and  dressing  it  in  the 
best  possible  manner  ;  but  I  consider  that  it  must  be  care- 
fully and  perseveringly  managed  both  by  surgeon  and 
nurses  for  the  space  of  thirty  or  forty  days,  inspecting 
frequently  the  situation  of  body  and  limb  of  the  patient ; 
altering  position  of  one  or  both,  whenever  their  appear- 
ance should  indicate ;  bearing  in  mind,  when  we  compare 
the  broken  with  the  sound  limb,  that  there  is  a  possibility 
of  our  being  deceived  in  the  length  of  the  thigh  by  the 
position  of  the  body.  If  I  succeed  in  keeping  the  limb 
perfectly  in  place  the  first  fifteen  or  twenty  days,  I  con- 
sider the  risk  of  after-displacement  but  small,  with  a 
common  share  of  prudence  ;  but,  on  the  contrary,  if  there 
is  frequent  movement  of  the  fractured  bone  during  this 
period,  the  confinement  must  be  much  longer  and  more 
rigid ;  and,  even  then,  there  will  be  a  greater  liability  to 
deformity.  Whenever  I  find  the  least  displacement, 
which  is  frequently  the  case,  I  immediately  endeavor  to 
remedy  it,  either  by  altering  the  position  of  the  limb,  or 
by  the  application  of  compresses  and  splints,  or  by  exten- 
sion, as  the  case  may  require.  In  one  case,  the  third 
week  after  the  accident,  the  union  of  the  fragments  hav- 
ing commenced,  I  left  my  patient  for  a  few  days,  when  I 
returned  and  found  a  very  considerable  curvature  of  the 
thigh  laterally  and  outwardly,  which  I  succeeded  in  re- 


FRACTURE    OF    THE    THIGH-BONE.  195 

moving  completely  in  a  few  days,  without  any  extension, 
merely  by  the  proper  application  of  compresses,  splints, 
and  bandages.  The  time  necessary  for  a  perfect  consoli- 
dation of  a  broken  bone  is  very  different  in  different  sub- 
jects, under  the  various  circumstances  of  age,  health,  and 
the  injury  received.  Owing  to  this,  there  is  sometimes 
an  unexpected  shortening  of  the  limb  after  the  fragments 
have  been  retained  in  place  the  usual  time  necessary  for  a 
complete  union,  and  the  patient  then  prematurely  begins  to 
use  his  legs.  Taking  the  foregoing  view  of  the  subject, 
in  my  opinion  it  must  appear  evident  to  every  well-in- 
formed person,  how  unreasonable  it  is  that  a  surgeon  who 
first  dresses  a  broken  thigh,  and  has  afterwards  no  special 
care,  should  be  considered  accountable  for  every  deformity 
which  may  take  place. 


196 


APPENDIX    H. 


Like  the  preceding  paper,  the  following  was  found  among  Dr. 
TwitchelTs  manuscripts.  Its  date  is  unknown ;  but  it  is  evidently 
the  rough  draft  of  an  answer  to  a  Committee  who  had  consulted 
him  on  the  subject  of  Temperance. 

EFFECTS  OF  ARDENT  SPIRITS  ON  THE  HUMAN 
SYSTEM. 

To  say  what  proportion  of  our  diseases  are  produced 
by  ardent  spirits  would  be  impossible ;  for,  in  many  in- 
stances, the  remote  cause  of  disease  is  hidden  from  our 
sight.  But  all  who  have  paid  any  attention  to  the  sub- 
ject will  agree  with  me  in  saying,  that  the  effect  upon  the 
human  constitution,  even  when  they  are  used  only  in  what 
is  called  a  temperate  manner,  is  to  dispose  to  almost  every 
form  of  acute  disease  ;  and  there  is  scarcely  any  form  of 
chronic  disease  which  has  not  at  times  been  excited  by 
the  habitual  use  of  ardent  spirits.  Persons  who  are  pre- 
disposed to  diseases  from  other  causes  frequently  excite 
them  by  the  use  of  ardent  spirits ;  whereas  by  a  total  ab- 
stinence they  might  escape.  This  predisposition  to  disease 
is  sometimes  inherited  from  intemperate  parents. 

To  point  out  the  various  ways  in  which  ardent  spirits 
produce  disease  cannot  be  expected  of  me  at  this  time. 
But,  from  the  attention  I  have  paid  to  the  subject,  in 


EFFECTS    OF    ARDENT    SPIRITS.  197 

watching  their  effects  upon  the  human  system,  and  investi- 
gating the  remote  and  proximate  causes  of  disease,  I  have 
come  to  the  conclusion,  that  more  than  one-half  of  all  the 
disease  amongst  us,  especially  in  adults,  is  in  one  way  or 
another  produced  by  their  use. 

You  inquire  in  what  degree  ardent  spirits  are  useful  in 
preserving  health,  or  in  curing  disease.  They  are  not 
absolutely  necessary  in  either  case.  I  am  aware  that  the 
celebrated  Rush  points  out  two  cases  in  which  spirits  may 
be  administered  with  safety  and  advantage:  1.  When 
the  body  has  been  suddenly  exhausted  of  its  strength, 
and  a  disposition  to  faintness  is  perceived ;  2.  When  the 
body  has  been  exposed  for  a  long  time  to  wet  weather, 
more  especially  if  combined  with  cold.  These  are  the 
only  two  cases  in  which  he  allows  distilled  spirits  to  be 
useful  to  persons  in  health.  In  the  first  of  which,  water 
of  ammonia  or  sulphuric  ether  will  answer  every  purpose  ; 
and,  in  the  latter,  a  cup  of  warm  tea  or  coffee,  and  at  the 
same  time  rubbing  the  surface  with  a  warm  flannel,  or 
with  tepid  water  in  which  is  dissolved  a  little  salt  would 
be  far  preferable. 

In  curing  diseases,  ardent  spirits  are  entirely  unneces- 
sary. 

It  is  the  vulgar  opinion,  that  the  use  of  spirits  is  bene- 
ficial in  preventing  contagion.  But  every  medical  practi- 
tioner of  any  observation  will  bear  testimony  against  this 
error.  I  am  fully  convinced  from  observing  facts,  that 
nurses  and  other  attendants  upon  sick,  who  totally  abstain 
from  drinking  alcoholic  liquors,  are  not  so  liable  to  contract 
disease  as  those  who  are  in  the  habitual  use  of  them. 

The  Committee  will  excuse  this  hasty  and  imperfect 
reply  to  their  inquiries,  when  they  reflect  that  my  time 
and  attention  are  constantly  taken  up  by  my  professional 
duties. 

17* 


198 


APPENDIX    I. 


The  following  very  interesting  case,  which  occurred  under  the 
care  of  Dr.  Twitch  ell,  was  published  by  his  nephew,  Dr.  Bemis, 
of  Medford,  in  the  "  Boston  Medical  and  Surgical  Journal," 
vol.  xviii.  p.  120.  Dr.  Bemis  was,  at  the  date  of  publication,  one 
of  Dr.  Twitchell's  students.  The  case  is  referred  to  on  page  139 
of  Memoir. 

CARCINOMATOUS  SARCOMA  IN  THE  MUSCLES  OF 
THE  ARM. 

21st  February,  1838.  —  I.  P.  a  man  of  twenty-two 
years  of  age,  presented  himself  with  a  disease  of  the  left 
arm.  He  says  that,  about  three  years  since,  in  lifting  a 
heavy  weight,  he  sprained  the  shoulder-joint  of  this  arm 
severely  ;  and,  a  day  or  two  afterwards,  he  was  exposed 
to  cold  and  wet,  which,  he  thinks,  had  some  effect  in  ag- 
gravating the  injury.  The  functions  of  the  joint  remained 
somewhat  impaired  for  about  two  months  after  this  acci- 
dent ;  at  the  expiration  of  which  time,  he  perceived  several 
hard  gristly  prominences  on  the  arm,  near  the  insertion 
of  the  deltoid  muscle.  These  gradually  increased,  and 
subsequently  coalesced ;  so  that  a  hard,  gristly  ridge  com- 
pletely encircled  the  arm  at  this  part.  The  swelling  gra- 
dually extended  upwards  and  downwards ;  so  that  ulti- 
mately the  whole  upper  arm,  and  portions  of  the  muscles 
over  the  scapula,  and  of  the  pectoralis  major,  became  im- 


CASE    OP    CARCINOMATOUS    SARCOMA.  199 

plicated  in  the  disease.  The  arm  is  nearly  three  times 
larger  than  the  other.  The  glands  in  the  axilla  are  a 
little  larger  and  harder  than  is  natural.  The  swelling  is 
hard  and  firm ;  it  does  not  give  the  irregular,  scaly  feel- 
ing of  osteo-sarcoma,  but  seems  to  be  fibro-cartilaginous, 
rather  than  bony.  The  superficial  veins  over  the  diseased 
parts  are  much  enlarged.  The  disease  has  been  almost 
unremittingly  attended  with  sharp,  lancinating  pain,  ex- 
tending downwards  to  the  elbow  joint,  and  upwards  to 
the  neck  and  back  of  the  head ;  and  the  patient  has  been 
at  times  troubled  with  very  severe  headache,  which  he 
referred  to  the  back  of  the  head. 

The  patient  has  employed  a  variety  of  remedies,  by  the 
advice  of  different  professional  gentlemen.  The  arm  has 
been  freely  leeched  and  cupped.  He  has  taken  largely 
of  iodine,  in  the  form  of  potass,  hydriod.  ;  an  issue  was 
kept  open,  for  two  or  three  months,  on  the  lower  part  of 
the  upper  arm,  the  discharge  from  which  was  copious, 
consisting  of  thin,  sanious  pus.  In  short,  all  the  reme- 
dies usual  in  such  cases  have  been  unavailingly  exhibited, 
not  even  mitigating  the  pain.  He  is,  of  course,  much 
emaciated  and  weakened ;  but  his  general  health  seems 
to  be  pretty  good.  The  functions  of  the  digestive  organs 
are  unimpaired ;  he  has  no  cough ;  and  auscultation  gives 
the  healthy  sound.  He  is  very  desirous  that  an  operation 
should  be  performed  ;  and,  as  it  is  thought  the  removal 
of  the  diseased  parts  will  afford  him  some  chance  of  at 
least  temporary  benefit,  the  operation  of  removing  the 
arm,  together  with  the  scapula  and  a  part  of  the  clavicle, 
has  been  decided  upon. 

24th  February.  —  The  operation  was  performed  to-day, 
at  ten  o'clock.  The  axilla  having  been  shaved,  an  inci- 
sion was  made  through  the  integuments,  commencing  near 
the  inferior  point  of  the  scapula,  extending  upwards  and 


200  APPENDIX    I. 

forwards,  and  passing  about  two  and  a  half  inches  in  front 
of  the  coracoid  process ;  another  incision,  commencing 
over  the  middle  of  the  clavicle,  was  carried  downwards 
and  forwards  to  meet  the  first.  The  integuments  were 
then  dissected  up  from  over  the  clavicle :  this  bone  was 
sawed  through,  with  Hey's  saw,  at  about  its  middle,  and 
disarticulated  from  the  scapula.  The  subclavian  artery, 
which  had  been  compressed  on  the  first  rib,  was  easily 
secured.  The  integuments  were  next  dissected  up  from 
over  the  scapula ;  that  bone  was  removed  from  its  attach- 
ment on  the  under  side  ;  and  the  sub-scapular  artery,  and 
two  small  branches  which  required  the  ligature,  were 
secured.  The  operation  was  concluded  by  forming  a 
small  portion  of  flap  from  the  axilla.  The  whole  opera- 
tion occupied  twenty-five  minutes  ;  part  of  this  time  was 
lost  on  account  of  the  fainting  of  the  patient.  Not  more 
than  half  a  pint  of  blood  was  lost. 

On  dissection,  it  was  found  that  the  muscles  of  the 
upper  arm,  with  the  exception  of  a  small  part  of  the 
biceps  flexor  cubiti,  were  entirely  converted  into  a  hard, 
fibro-cartilaginous  mass,  through  which  irregular  striated 
lines  passed  in  different  directions.  The  inter-muscular 
fascia  seemed  to  have  resisted  the  disease  longest:  it 
could  be  distinctly  made  out  in  many  places.  The  bra- 
chial artery  was  unobstructed ;  but  its  coats  were  con- 
verted into  something  very  like  cartilage.  The  articular 
cartilages  of  the  shoulder  and  elbow  joints  were  partially 
absorbed.  On  the  outer  side  of  the  fore  arm,  two  or  three 
small  indurated  spots  were  observed ;  which,  when  cut 
into,  were  found  to  correspond  in  appearance  to  the  dis- 
ease on  the  upper  arm.  The  os  brachii  was  of  the  natural 
size,  but  very  rough  and  fragile  ;  it  was  accidentally  broken 
at  the  neck,  during  dissection,  by  the  fingers.  The  dis- 
ease was  undoubtedly  carcinomatous  sarcoma. 


CASE    OF    CARCINOMATOUS    SARCOMA.  201 

The  patient  supported  the  operation  very  well.  Imme- 
diately on  its  conclusion,  he  was  put  to  bed,  and  tinct. 
opii.  gtts.  70,  were  directed. 

4  o'clock,  p.m.  —  The  patient,  considering  the  circum- 
stances, is  comfortable.  Re-action  has  come  on  mode- 
rately. Breathing  regular.  Pulse  82,  full.  He  is 
somewhat  incommoded  by  spasmodic  twitching  in  the 
wound.     An  opiate  was  ordered  at  bedtime. 

The  dressings  were  removed  seventy-two  hours  after 
the  operation.  Union  by  the  first  intention  had  taken 
place.  There  was  no  suppuration,  except  what  was 
caused  by  the  ulceration  around  the  stitches.  The  liga- 
ture on  the  subclavian  came  away  on  the  nineteenth  day. 
Some  portions  of  the  cut  surface  around  the  ligature, 
which  were  not  united  by  the  first  intention,  healed  kindly 
by  granulation.  The  patient  recovered  his  strength  very 
rapidly,  sitting  up  most  of  the  time,  and  walking  out 
daily,  after  the  removal  of  the  ligature.* 

*  This  patient  died,  about  two  years  after  the  operation,  of  car- 
cinoma of  an  internal  organ. 


202 


APPENDIX    J. 


The  account  of  this  case  may  be  found  in  the  "  Boston  Medical 
and  Surgical  Journal,"  vol.  xviii.  p.  169.  It  is  republished  as  ori- 
ginally communicated  by  Dr.  Bemis. 

LITHOTOMY.  —  OPERATION  OX  A  FEMALE. 

A  S.  a  deaf  and  dumb  married  woman,  aet.  thirty- 
three  years,  presented  herself  on  the  7th  February,  1838, 
for  admission  into  the  private  hospital  of  my  medical  in- 
structor, Dr.  Twitchell.  On  examination,  this  patient 
was  found  to  present  the  ordinary  symptoms  of  urinary 
calculus ;  and,  on  the  introduction  of  the  sound,  a  stone 
was  distinctly  felt.  The  urethra  was  exquisitely  tender, 
the  introduction  of  a  common-sized  catheter  causing  great 
pain ;  and  an  application  was  made  of  an  ointment  con- 
taining ext.  belladonnae  and  plumb,  acet.  with  the  view 
of  diminishing  this  morbid  sensibility.  The  usual  attempt 
to  extract  the  stone  by  dilating  the  urethra  was  made ; 
but,  on  account  of  its  large  size  and  the  tenderness  of  the 
urethra,  its  removal,  by  this  means,  was  not  effected  ;  and 
the  operation  of  lithotomy  was  decided  upon. 

The  operation  was  performed  on  the  13th  February. 
The  patient  having  been  placed  on  the  table,  and  bound 
in  the  usual  manner,  the  bladder  being  full,  a  sound  was 
introduced,  and  the  position  of  the  stone  ascertained.  It 
occupied  the  same  place  as  when  first  sounded,  and  was 
not  movable.  The  sound  was  then  withdrawn,  and  a 
grooved  staff  introduced  in  its  place.     Two  fingers  of  the 


CASE    OF    LITHOTOMY.  203 

left  hand  of  the  operator  being  in  the  vagina  to  protect 
that  from  injury,  the  beak  of  the  gorget  was  introduced 
into  the  groove,  and  pushed  along  through  the  whole 
course  of  the  urethra,  dividing  it  laterally.  The  staff  and 
gorget  having  been  withdrawn,  a  small  pair  of  forceps 
was  introduced  ;  and  the  stone  was  readily  found  and 
grasped,  and  easily  extracted,  though  it  was  slightly  ad- 
herent to  the  bladder.     The  hemorrhage  was  trifling. 

The  patient  was  put  to  bed,  and  an  opiate  was  directed. 
No  dressings  or  stitches  were  made ;  but  she  was  kept 
on  the  back,  with  the  thighs  drawn  together.  On  the 
third  day  after  the  operation,  an  examination  was  made 
by  introducing  a  catheter  into  the  urethra,  and  the  fingers 
into  the  vagina ;  and  it  was  found  that  there  was  a  perfect 
union.  The  patient  amended  rapidly ;  and  on  the  26th 
February  went  home,  perfectly  well,  except  that,  on  ac- 
count of  irritability  of  the  coats  of  the  bladder,  she  was 
unable  to  contain  so  large  a  quantity  of  urine  as  is  usual. 

I  take  the  liberty  to  send  you  this  account,  not  as 
being  that  of  a  very  unusual  or  remarkable  case,  but  from 
having  noticed  a  report  of  a  similar  operation  in  the  7th 
No.  of  vol.  xviii.  of  your  Journal ;  in  commenting  upon 
which,  the  writer  reprobates  very  strongly  the  method 
of  operating  pursued,  ridiculing  the  idea  that  the  urethra 
can  unite  under  the  circumstances,  and  asking  if  "  the 
dividing  the  urethra  does  not  perfectly  destroy  all  chance 
of  recovery. "  In  this  case,  at  least,  it  did  not.  Many 
surgical  writers  on  lithotomy  say  nothing  of  the  operation 
on  the  female ;  but,  in  answer  to  the  inquiry,  "  Is  there 
any  authority,  to  say  nothing  about  common  sense,  in  the 
matter?"  I  would  refer  him  to  Desault's  Surgery,  to  Mr. 
Benjamin  Bell's  System  of  Surgery,  and  to  Sir  Astley 
Cooper's  Lectures  as  reported  by  Mr.  Travers  ;  —  authori- 
ties which  no  one  will  probably  feel  inclined  to  question. 


204 


APPENDIX    L. 


In  the  Memoir,  page  101,  I  have  alluded  to  Dr.  Twitchell's  views 
on  the  effects  of  tobacco  upon  the  human  system.  The  following 
is  an  abstract  of  a  lecture  delivered  by  him :  *  — 


EFFECTS  OF  TOBACCO  ON  THE  HUMAN  SYSTEM. 

At  the  meeting  of  the  Western  District  New  Hamp- 
shire Medical  Society,  at  the  Temperance  House  in 
Keene,  May  5,  1842,  Dr.  Twitchell,  having  been  ap- 
pointed to  address  the  meeting,  selected  for  his  subject 
the  habitual  use  of  tobacco,  and  its  effects  on  the  consti- 
tution. 

In  discussing  this  subject,  the  doctor  first  described  the 
effects  it  has  on  the  nervous  system,  particularly  the  nerves 
of  involuntary  motion,  —  those  whose  function  it  is  to 
carry  on  the  action  of  the  lungs,  heart,  and  stomach. 
These  nerves  are  placed  beyond  the  power  of  the  will, 
acting  without  our  consciousness,  in  sleep  as  well  as  when 
awake.  And  it  is  on  these,  he  said,  the  habitual  use  of 
tobacco  produces  its  most  pernicious  effects,  by  paralyzing 
their  action. 

It  first  manifests  itself  in  the  respiration,  which  is  im- 
perfectly performed ;  the  blood  is  not  fully  purified,  and 
a  sense  of  anxiety  or  incipient  suffocation  is  felt ;  to  re- 

*  Lectures  to  Young  Men  on  their  Moral  Dangers  and  Duties, 
by  Abiel  Abbot  Livcrmore.   Boston  :  James  Munroe  and  Co.    1847. 


EFFECTS    OF    TOBACCO.  205 

lieve  which,  a  voluntary  effort  is  made  to  expand  the  chest 
to  take  in  more  air ;  and,  every  now  and  then,  a  deep  in- 
spiration or  sigh  is  the  result,  giving  momentary  relief. 

But,  during  sleep,  especially  when  first  going  to  sleep, 
the  will  not  being  so  easily  excited  to  action,  the  sense  of 
suffocation  is  longer  endured,  till,  at  length,  becoming 
urgent  and  painful,  a  degree  of  consciousness  is  awakened, 
the  individual  begins  to  feel  his  condition,  and  rouses, 
perhaps  suddenly  starts,  and  sits  up  in  the  bed  in  alarm,  his 
heart  palpitating  violently  ;  and,  having  obtained  relief, 
soon  goes  to  sleep,  to  pass  through  the  same  scenes  again. 

But,  as  the  habit  continues,  the  whole  nervous  system 
becomes  affected, — the  muscles  become  tremulous,  the 
sensibilities  diminish,  respiration  and  the  action  of  the 
heart  become  more  imperfect,  and  suffocation  more  urgent : 
but  consciousness  now  fails  to  be  roused  to  put  forth  a 
voluntary  effort  for  relief;  and  the  poor  abused  and  lan- 
guishing nerves,  whose  office  it  is  to  stand  sentinel  at  the 
fountains  of  life,  obtaining  no  help  from  the  muscles  of 
volition,  at  last  are  compelled  quietly  to  yield  up  the 
struggle;  and  the  person  is  found  dead  in  his  bed,  the 
cause  not  known.  Yet  it  is  a  foolish  sacrifice  of  life  to 
the  vile  but  enchanting  habit  of  using  tobacco. 

There  are  doubtless  some  few  who  are  found  dead  from 
disease  of  the  heart.  But  the  doctor  said  he  had  for 
many  years  been  extending  his  inquiries  on  this  subject ; 
that  he  had  found  almost  every  individual,  who  had  died 
during  sleep,  had  long  been  in  the  habit  of  the  free  use 
of  tobacco,  and  it  was  his  full  conviction  that  that  was 
almost  the  only  cause  of  such  deaths. 

The  habitual  use  of  tobacco,  he  said,  was  a  most  fruit- 
ful source  of  disease.  And  this  would  appear  evident 
when  we  consider  its  effects  upon  the  nervous  system.  It 
lowers  down  the  power  of  those  nerves  upon  which  life 
18 


203 


APPENDIX    L. 


depends  ;  the  blood  does  not  fully  undergo  that  change 
in  the  lungs  which  respiration  is  designed  to  effect,  and 
goes  to  the  heart  impure  and  purple  ;  the  heart  has  not 
its  original  power  to  send  it  forward  in  its  circulation 
through  the  body  ;  and  an  impure,  sluggish  circulation 
is  the  consequence,  which  predisposes  to  almost  every 
disease  the  human  system  is  subject  to. 

Among  the  diseases  caused  by  tobacco,  the  doctor  enu- 
merated palsy,  inveterate  nervous  headache,  palpitation 
of  the  heart,  disease  of  the  liver,  indigestion,  ulceration  of 
the  stomach,  piles,  and  many  others  ;  and  finally,  he  said, 
he  hardly  knew  that  there  was  any  disease  it  did  not  at 
times  produce.  He  did  not  undertake  to  assert,  that  all 
who  use  tobacco  must  necessarily  have  these  diseases 
fully  developed.  But  he  said  individuals  often  experienced 
annoying,  and  sometimes  alarming  symptoms,  the  result 
of  tobacco,  which  render  them  infirm  and  wretched,  while 
they  are  altogether  ignorant  of  the  cause.  He  mentioned 
giddiness,  pain  in  the  head,  palpitation  of  the  heart, 
faintness,  and  gnawing  sensation  of  the  stomach,  neu- 
ralgic pains,  trembling,  sudden  loss  of  strength,  loss  of 
recollection,  starting  in  sleep,  &c. ;  that  he  had  been 
called  to  prescribe  for  a  great  many  persons,  whose  dis- 
eases have  spontaneously  disappeared  on  their  discon- 
tinuance of  tobacco. 

The  particular  form  in  which  tobacco  is  used  is  not  of 
very  material  consequence.  He  thought  tobacco  more 
frequently  produces  palsy  than  all  other  causes,  and  that 
snuff  is  more  likely  to  bring  it  on  than  any  other  form  in 
which  it  is  used;  but  that  chewing  is  more  injurious  to 
the  digestive  organs,  affecting  them  in  a  threefold  way. 
It  robs  the  stomach  of  its  saliva,  lessens  its  nervous 
power,  and  diminishes  its  peristaltic  motion  ;  and  all 
the  cases  he  had  seen  of  ulceration  of  the  stomach  were 
manifestly  the  effects  of  tobacco. 


207 


APPENDIX    M. 


The  following  paper  was  prepared  by  the  author  of  the  Memoir, 
and  is  the  result  of  investigations  made  by  members  of  the 
Boston  Society  for  Medical  Observation.  The  subject  seems 
appropriate,  because  the  investigation  was  undertaken  in  conse- 
quence of  a  conversation  held  with  Dr.  Twitchell  upon  the 
symptoms  attending  the  use  of  tobacco.  See  Memoir,  p.  101, 
and  Appendix  L. 

OBSERVATIONS  ON  THE  EFFECTS  OF  TOBACCO  ON 
THE  HUMAN  SYSTEM. 

In  1848,  it  was  proposed  to  the  Boston  Society  for 
Medical  Observation  to  investigate  some  of  the  points 
suggested  by  Dr.  Twitchell,  particularly  with  reference  to 
the  dyspnoea  and  disposition  to  sigh,  and  to  have  night- 
mare, evinced  by  those  in  the  habitual  use  of  tobacco. 
In  one  hundred  and  eighty-five  cases,  questions  were 
made;  and  the  results,  though  in  some  respects  imper- 
fect, rather  confirm  the  views  of  Dr.  Twitchell.  It  ap- 
peared from  these  investigations,  that  some  may  continue 
the  use  of  tobacco,  in  a  moderate  way,  for  many  years, 
without  any  apparent  symptoms  ;  but,  if  disposed  to  use 
it  more  freely,  they  will  be  very  liable  to  various  func- 
tional diseases.  The  following  table  illustrates  this  as- 
sertion :  — 


203  APPENDIX    M. 

Among  thoso  Amonr  those 

hiring  efmptomj.       not  having  symptom*. 

Average  time  tobacco  was  used       .     .     .    15  yrs.  13i-3yrs. 

„        amount  of  cigars  daily        ...      42-5  cig.        2  1-4  cig. 
„        amt.  of  tobacco  chewed  per  mo.  .    16  2-3  oz.       13  i3-is  oz. 

Dyspnoea,  taking  the  word  in  its  most  general  sense, 
was  as  liable  to  occur  in  those  who  had  not  used  tobacco, 
as  in  those  who  had  indulged  in  that  habit.  But  it  was 
trifling  in  character,  and  scarcely  noticed  in  the  former ; 
while,  at  times,  it  was  very  severe  in  the  latter  class. 

A  disposition  to  sigh  or  gape  frequently  was  noticed  in 
both  classes  of  persons  ;  but  it  was  much  more  manifest 
in  the  tobacco-chewers  than  in  others.  One  said,  he 
6ighed  voluntarily  to  "  fill  his  chest."  In  two,  the  habit 
and  need  wholly  disappeared,  when,  under  the  advice  of 
physicians,  they  abstained  from  the  use  of  tobacco. 

Night-mare,  usually  in  the  early  part  of  the  night,  was 
at  times  a  most  horrible  accompaniment  of  an  inordinate 
use  of  tobacco,  although,  of  course,  it  is  a  symptom  liable 
to  occur  in  any  class  of  patients. 

The  following  exceedingly  interesting  case  occurred  in 
my  own  practice :  A  large,  gross,  sallow-looking  man, 
with  congested  eyes,  and  having  all  the  aspect  of  a  bon 
vivant  in  a  coarse  way,  consulted  me  for  what  he  supposed 
to  be  disease  of  the  lungs  or  heart.  His  chief  complaints 
were  some  palpitation  and  a  pain,  with  soreness  of  the 
breast.  He  attributed  these  symptoms  to  a  strain  re- 
ceived many  years  ago.  He  had  always  led  an  active  life, 
and  all  his  functions  seemed  healthy.  Upon  auscultation 
of  the  chest,  the  thoracic  organs  were  found  to  be  normal. 
It  appeared,  however,  first,  that  he  had  used  on  an  average 
twelve  cigars  daily  for  the  five  previous  years,  having 
been,  moreover,  an  inveterate  smoker  for  some  time  before 
that  period.  He  had  not  chewed  or  taken  snuff.  The 
description  he  gave  of  his  "horrible"  nightmare,  as  he 


OBSERVATIONS  ON  THE  EFFECTS  OF  TOBACCO.   209 

expressed  himself,  was  as  follows  :  "  Soon  after  going  to 
sleep,  I  suddenly  awake  to  a  consciousness  of  intense 
difficulty  of  breathing,  and  a  sensation  as  of  approaching 
suffocation.  I  feel,  however,  unable  to  free  myself.  I 
cannot  move,  although  sensible  that,  if  any  one  will  vio- 
lently shake  me,  the  spell  will  be  broken.  It  hurts  me  to 
attempt  to  move.  "Under  these  circumstances,  I  begin  to 
groan  aloud,  and  endeavor  to  make  as  many  signs  of 
distress  as  I  can  in  order  to  arouse  my  friends.  While  I 
was  married,  my  wife  usually  shook  me,  and  after  a  time 
the  fit  went  off."  Unfortunately,  the  worthy  gentleman 
became  a  widower ;  and  then,  continued  he,  "  I  made  an 
arrangement  for  my  sister  to  sleep  in  the  adjacent  room, 
with  a  door  open  between  the  apartments,  in  order  that 
she  might  do  me  the  same  favor  that  my  wife  had  per- 
formed. In  fact,  I  really  believe  that  I  was  induced  to 
marry  a  second  time,  much  more  on  this  account  than 
any  other !  On  one  occasion,  before  my  second  marriage, 
I  think  I  was  very  near  dying.  My  sister  was  a  long 
while  before  coming  to  my  aid  ;  and  I  was  so  exhausted  by 
my  efforts  at  groaning,  that,  when  she  entered  the  room, 
I  ceased  making  any  exertion.  You  may  imagine  my  hor- 
ror at  seeing  her  turn  to  leave,  thinking  that  the  fit  was 
over.  I  began  again  with  great  difficulty  to  show  my  usual 
signs  of  distress,  and  I  did  not  and  could  not  arouse  my- 
self until  the  accustomed  shaking  had  been  undergone." 
He  told  me  that  he  had  frequently  felt  his  pulse,  when 
recovering  from  these  fits  of  nightmare,  and  had  found  it 
fluttering.  These  accesses  were  almost  sure  to  happen,  if 
he  indulged  in  any  excitement.  I  advised  him  wholly  to 
throw  aside  the  use  of  tobacco.  Being  a  resolute  man, 
he  followed  my  advice  ;  and  for  three  months  he  abstained 
wholly,  with  entire  relief  to  his  symptoms  about  the  chest, 
and  to  his  nightmare.     At  the  end  of  that  period,  he  had 


210  APPENDIX    M. 

a  slight  paralysis  of  the  arm,  with  a  short  fit  of  uncon- 
sciousness. By  the  advice  of  another  physician,  he  re- 
sumed in  moderation,  about  one  or  two  cigars  daily ; 
and,  at  the  time  I  saw  him  last,  he  had  not  experienced 
any  return  of  the  difficulty. 

In  regard  to  the  various  symptoms  of  indigestion,  I 
have  no  doubt,  from  our  investigations,  that  they  are 
liable  to  occur  from  the  use  of  tobacco.  These  symptoms 
are  often  produced  by  a  slight  use  of  the  narcotic  ;  but, 
of  course,  they  are  worse  in  those  persons  who  use  it  in- 
ordinately. 

The  following  very  interesting  case  was  related  to  me 
by  Dr.  Buckingham,  of  this  city  :  The  patient  was  an 
old  woman,  who  had  been  for  years  an  inveterate  smoker. 
After  smoking  much  of  the  day,  she  could  not  sleep  with- 
out lighting  her  pipe  two  or  three  times  during  the  night. 
For  two  years  before  Dr.  Buckingham  saw  her,  she  had 
not  walked  two  rods  from  her  own  door-step,  and  always 
used  a  staff  for  her  support.  She  had  had  constant  pain 
in  the  occiput,  and  cramp  in  the  legs,  with  obstinate  con- 
stipation, the  bowels  never  operating  unless  stimulated  by 
the  most  drastic  purges.  In  July,  1848,  she  had  cholera 
morbus,  and  was  treated  with  opium  and  recovered. 
Since  that  period,  she  has  used  no  tobacco.  She  can  now 
walk  a  mile  without  a  cane,  is  free  from  headache  and 
constipation,  having  not  used  a  cathartic  since  her  illness. 

In  six  cases,  palpitations  were  produced  ;  and  in  eight, 
pains  in  chest  usually  over  the  heart,  but  at  times  at  the 
right  side  of  the  breast.  In  two  of  these  it  was  noticed 
particularly  after  immoderate  use  of  tobacco. 

Headache  was  observed  four  times,  and  frightful  and  se- 
vere dreams  in  four  more  cases.  Xervous  tremors,  cramps, 
starting,  <kc.  were  found  eleven  times.  In  one  case  the 
memory  was  benumbed,  and  the  patient  became  stupid. 


OBSERVATIONS  ON  THE  EFFECTS  OF  TOBACCO.  211 

The  following  was  told  to  me  as  the  personal  expe- 
rience of  a  very  sagacious  medical  man  :  "  For  five  years 
I  had  been  accustomed  to  chew  one  cubic  inch  of  tobacco 
daily.  From  April,  1847,  to  April,  1848,  I  had  been 
liable  to  attacks  of  severe  headache,  of  an  entirely  local 
character,  usually  over  one  or  the  other  parietal  bone.  It 
seemed  as  if  an  instrument  were  boring  into  my  skull,  and 
caused  intense  suffering.  With  this  were  slight  nausea 
and  diarrhoea,  commonly  in  the  morning  before  the  pain 
began.  This  last  began  at  nine,  a.m.  and  continued  till 
sundown.  At  first,  these  attacks  were  but  seldom ;  but, 
by  the  middle  of  April,  they  recurred  three  times  a  week, 
wholly  unfitting  me  for  all  mental  or  physical  labor. 
My  father  (a  physician)  at  length  persuaded  me  to  give 
up  the  use  of  tobacco.  For  three  weeks  I  gained  no  relief, 
either  in  the  frequency  or  severity  of  the  attacks.  Then 
they  became  less  severe  and  gradually  less  frequent,  so 
that,  by  July  1, 1  was  wholly  rid  of  all  trouble,  save  a  slight 
occasional  headache,  to  which  I  was  always  subject  from 
early  life."  The  above,  besides  being  a  very  interesting 
example  of  the  effects  of  tobacco,  illustrates  their  gradual 
growth,  and  their  almost  equally  gradual  disappearance. 

From  the  above  remarks  and  facts,  it  seems  evident  that 
Dr.  Twitchell  has  not  exaggerated,  when  saying  that 
symptoms  connected  with  the  cephalic,  thoracic,  or  abdo- 
minal organs  may  arise  in  tobacco-chewers.  From  a  re- 
view of  all  these  investigations,  I  infer,  first,  that,  though 
under  "  moderate "  use  of  tobacco  some  may  escape, 
they  are  by  no  means  certain  of  doing  so  ;  second,  that 
habitual,  inordinate  chewers  or  smokers  will  almost  inevi- 
tably suffer  more  or  less,  and  in  some  instances  they  will 
have  to  undergo  an  amount  of  torture  to  which  it  seems 
almost  impossible  to  believe  that  any  man  would  volun- 
tarily subject  himself,  merely  for  the  sake  of  gratifying  a 
beastly  appetite. 


212 


APPENDIX    N. 


LIST  OF  DIPLOMAS,  &c.  HELD  BY  DR.  TWLTCHELL. 

The  following  is  the  list  of  Dr.  Twitchell's  diplomas, 
and  certificates  of  membership  of  various  societies  :  — 

Degree  of  Bachelor  of  Arts,  1802. 
„         Master  of  Arts,  1805. 
,,         Bachelor  of  Medicine,  1805. 

New  Hampshire  Medical  Society,  1811. 

Overseer  of  Dartmouth  College,  1816. 

Dartmouth  Medical  Society,  1819. 

Massachusetts  Medical  Society,  Honorary  Member,  1838. 

Trusteeships    of   the    New    Hampshire    Insane    Asylum, 
1840,  &c. 

National  Institution  for  the  Advancement  of  the  Sciences, 
Washington,  1841. 

Northern  Academy  of  Arts  and  Sciences,  Hanover,  1841. 

Philadelphia    College    of    Physicians,    Honorary   Mem- 
ber, 1843. 

New  Hampshire  Historical  Society. 

American  Medical  Association. 


THE    END. 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 

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